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Giriş: Trizomi 13; ilk defa 1960’ ta tanımlanmış olup, mikrosefali, mikroftalmi, yarık damak dudak, mental retardasyon, polidaktili, konjenital kalp anomalileri, üriner sistem anomalileri ve santral sinir sistemi gelişim anomalileri sıklıkla eşilik etmektedir. Klasik trizomi, 47, XX/XY + 13, şeklinde olup daha nadir olarak translokasyon ve mozaisizm gibi kromozomal düzensizlikler de görülmektedir. Vaka: Tokat Gaziosmanpaşa Üniversitesi Hastanesi’ nde takip edilen 30 yasındaki annenin G2P2Y2 olarak 32 haftalıkken sezaryen ile 1405 gr olarak dünyaya gelen kız bebeğinin APGAR skoru 1. dakikada 5 ve 5. dakikada 6 idi. Fizik muayenesinde; kilosu 1405 gram (3 persentil altı), boyu 41 cm (3 persentil altı), baş çevresi 26 cm (3 persentil altı) idi. Dismorfik görünümü ve ön fontonel boyutu 3x4 cm olan hastanın mikrosefaliyle birlikte, skalpte sol paryetal alanda aplazia kutis konjenita, sağ gözde mikroftalmi, sol gözde anoftalmi, yarık damak ve dudak mevcuttu. Üç ekstremitede polidaktili olduğu görüldü. Abdomen ultrasonografi (USG), kranial USG ve beyin bilgisayarlı tomografide bir patoloji görülmedi. Ekokardiyografisi normal olarak değerlendirildi. Sağ gözde konjenital katarakt ve mikroftalmi mevcutken; sol göz anoftalmikti. Tartışma Trizomi 13’ün yaklaşık insidansı 10.000 canlı doğumda birdir. Vakamızda; FISH analizi trizomi 13 ile uyumlu bulunan hastadan moleküler karyotiplendirme ise yine 47, XX, + 13 olarak bulunmuştur. Trizomi 13 sendromunun en sık görülen bulguları motor ve mental gerilik, mikrosefali, mikroftalmi, holoprozensefali, hipotelorizm, yarık damak ve/veya yarık dudak, kardiovasküler, genitoüriner ve oküler malformasyonlardır. Mikroftalmi, yarık damak ve yarık dudak, polidaktili olması bu sendrom için karakteristiktir. Vakamızda yarık damak-dudak, polidaktili, sol göz anoftalmi, sağ göz mikroftalmi ve konjenital katarakt, mikrosefali, mikrognati eşlik etmektedir. Bununla birlikte Trizomi-13 vakalarında görülme sıklığı yüksek olan kardiyak anomali, santral sinir sistemi gelişim anomalisi, üriner sistem anomalisi görülmemiştir.

Objective: The aim of this study is to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in pediatric patients with epilepsy.Materials and Methods: A retrospective natural study design was used. Participants were pediatric patients with epilepsy who were treated with VPA only as monotherapy. Electronic medical files were reviewed for changes in hematological and biochemical parameters before and after a VPA treatment.Results: Eighty-five patients aged 3-18 (mean 10.52 ± 3.63) met the study criteria. 50 (58.9%) of the patients were girls. In the second year after starting the treatment, the platelet values of the patients were calculated as 249.32 ± 48.778 in patients using VPA, and this difference over the years is statistically significant. No serious side effects were reported.Conclusion: Epileptic patients treated with VPA may be at risk of decreased platelet count and elevated liver enzymes. Therefore, baseline measurement of liver function and haematological parameters and monitoring during therapy is recommended., Amaç: Bu çalışmanın amacı epilepsi tanılı çocuk hastalarda valproik asidin (VPA) uzun süreli hematolojik ve biyokimyasal yan etkilerini belirlemektir. Gereç ve Yöntem: Geriye dönük bir doğal çalışma tasarımı kullanılmıştır. Katılımcılar, monoteratpi şeklinde yalnızca VPA ile tedavi edilen epilepsi saptanan çocuk hastalardı. Elektronik tıbbi dosyalar, bir VPA tedavisi öncesi ve sonrasında hematolojik ve biyokimyasal parametrelerdeki değişiklikler için gözden geçirildi. Bulgular: Yaşları 3-18 (ort. 10,52 ± 3,63) olan 85 hasta çalışma kriterlerini karşıladı. Hastaların 50’sini (%58,9) kızlar oluşturmaktaydı. Tedaviye başladıktan sonraki ikinci yılda hastaların Trombosit değerleri VPA kullanan hastalarda ortalama 249,32 ± 48,778 olarak hesaplanmıştır ve yıllar içindeki bu farklılık istatistiksel olarak anlamlıdır. Hiçbir ciddi yan etki bildirilmedi.Sonuç: VPA ile tedavi edilen epileptik hastalar, trombosit sayısında azalma ve karaciğer enzimlerinde yükselme riski altında olabilir. Bu nedenle, karaciğer fonksiyonlarının ve hematolojik parametrelerin temel ölçümü ve tedavi boyunca izlenmesi önerilir.

Doğum dönemindeki gebelerde ve yenidoğanlarda daha az COVID-19 vakasıyla karşılaşıldığı için, anneden bebeğe dikey geçiş olasılığını destekleyecek oldukça kısıtlı sayıda kanıt bulunmaktadır. Olgumuzda COVID-19 PCR pozitif anneden doğan COVID-19 PCR pozitif bebeği doğumdan taburculuğuna kadarki takiplerimize yer vererek litarature dikey geçiş olasılığı hakkında katkı sağlamayı amaçladık.

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Tokat province. It is observed in all age groups. The case fatality rate varies 20-30% in hospitalized patients and 0-5% among children. Ribavirin use and supportive measures are the main treatment modalities, but the effects of ribavirin in CCHF are controversial. Most of the studies investigating the effectiveness of ribavirin are done by comparing the initial and the final laboratory values. The purpose of this study was to evaluate the effects of oral ribavirin use in children with CCHF by using all the clinical and laboratory findings and to investigate the presence of unnoticed results. In the study, the data of 67 patients under 19 years old who were hospitalized and followed up with a diagnosis of CCHF during 2012-2020 epidemic period were retrospectively analyzed. Epidemiological and demographic characteristics, clinical and laboratory data were retrieved from the patient files. We implemented a linear mixed-effects model to assess the effects of the ribavirin, taking into account the repeated measures of the data. Ribavirin was given to 33 (49.2%) of the patients. 54 (80.6%) of the patients were male, 13 (19.4%) were female, 52 (77.6%) of the patients were living in rural areas and 15 (22.4%) were living in urban areas. The mean age was 15.1 (median= 15.5, range= 8-18) years in patients who did not receive ribavirin, and 15.2 (median= 15, range= 11-18) years in ribavirin administered patients. At the time of admission 63 (94%) of the patients had fever, 60 (89.6%) had fatigue, 38 (56.7%) had rash, 48 (71.6%) had myalgia, 30 (44.8%) had headache, 25 (37.3%) had abdominal pain, 30 (44.8%) had vomiting, 21 (31.8%) had diarrhea, 29 (43.3%) had drowsiness, 29 (43.3%) had bleeding in the mucosa and 27 (40.3%) had petechiae. Drowsiness and mucosal bleeding rates were significantly higher in patients who received ribavirin (p

Objective The aim of this study was to determine the clinical characteristics, course of disease, and outcomes of patients admitted to our pediatric intensive care unit (PICU) for Crimean–Congo hemorrhagic fever (CCHF). Methods Data of all patients with CCHF who were admitted to PICU during a 3-year period and whose diagnosis was confirmed by serological methods or polymerase chain reaction were retrospectively reviewed. Their presenting characteristics, treatments, and outcomes were extracted from the hospital's electronic database. Disease severity scoring was performed using the severity scoring index and severity grading score system. Results The data of 22 of 123 patients with suspected CCHF who were admitted to PICU were evaluated. Among them, 68.2% were males and mean age of all patients was 13.4 ± 2.2 years. The average length of stay of 10 patients was >10 days. On average, 3.72 units of platelet suspension per patient was transfused. In the course of the disease, the highest laboratory values were reached on day 3 of admission. Conclusion Poor CCHF outcome depends on thrombocytopenia severity, prolonged coagulation tests, high-liver enzyme levels, and disseminated intravascular coagulation. Poor outcomes can be avoided by CCHF awareness and preparedness, early diagnosis of the disease, and supportive treatment with appropriate fluid and blood product transfusion. Randomized controlled trials on prophylactic transfusion and ribavirin use are needed.

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Tokat province. It is observed in all age groups. The case fatality rate varies 20-30% in hospitalized patients and 0-5% among children. Ribavirin use and supportive measures are the main treatment modalities, but the effects of ribavirin in CCHF are controversial. Most of the studies investigating the effectiveness of ribavirin are done by comparing the initial and the final laboratory values. The purpose of this study was to evaluate the effects of oral ribavirin use in children with CCHF by using all the clinical and laboratory findings and to investigate the presence of unnoticed results. In the study, the data of 67 patients under 19 years old who were hospitalized and followed up with a diagnosis of CCHF during 2012-2020 epidemic period were retrospectively analyzed. Epidemiological and demographic characteristics, clinical and laboratory data were retrieved from the patient files. We implemented a linear mixed-effects model to assess the effects of the ribavirin, taking into account the repeated measures of the data. Ribavirin was given to 33 (49.2%) of the patients. 54 (80.6%) of the patients were male, 13 (19.4%) were female, 52 (77.6%) of the patients were living in rural areas and 15 (22.4%) were living in urban areas. The mean age was 15.1 (median= 15.5, range= 8-18) years in patients who did not receive ribavirin, and 15.2 (median= 15, range= 11-18) years in ribavirin administered patients. At the time of admission 63 (94%) of the patients had fever, 60 (89.6%) had fatigue, 38 (56.7%) had rash, 48 (71.6%) had myalgia, 30 (44.8%) had headache, 25 (37.3%) had abdominal pain, 30 (44.8%) had vomiting, 21 (31.8%) had diarrhea, 29 (43.3%) had drowsiness, 29 (43.3%) had bleeding in the mucosa and 27 (40.3%) had petechiae. Drowsiness and mucosal bleeding rates were significantly higher in patients who received ribavirin (p0.05). The time from tick bite to hospital admission was 4.85 (median= 4.5, range= 2-9) days in patients who did not receive ribavirin, and 4.64 (median= 5, range= 2-9) days in ribavirin administered patients. The mean length of the hospital stay in patients who did not receive ribavirin was 6.68 (median= 7, range= 4-10) days, while it was 7.45 (median= 8, range= 3-13) days in those treated with ribavirin. Linear-mixed effect test results showed that ribavirin decreased hemoglobin (Hb) (95% GA= -0.12/-0.02), suppressed white blood cell count (WBC) (95% GA= -0.15/-0.02) and absolute lymphocyte count (ALC) (95% GA= -0.12/0.05), and decreased alanine aminotransferase (ALT) (95% GA= -9.32/-1.49), lactate dehydrogenase (LDH) (95% GA= -25.06/-2.36) and severity score index (95% GA= -0.28/-0.004). As a result, ribavirin suppressed Hb, WBC and ALC levels in children with CCHF, but decreased liver enzymes and severity score much faster in the elapsed time.

Objectives The aim of this study was to identify the genotypic analysis and allele frequencies of the –173 G/C polymorphism in the macrophage migration inhibitory factor (MIF) gene in children diagnosed with familial Mediterranean fever (FMF). Methods The study included 98 children who were diagnosed with FMF according to the Tel Hashomer criteria and one hundred and 57 healthy children as the control group. Genotyping was done for a polymorphism in a promoter region of the MIF gene (G/C at position –173). Results The relationship of FMF prevalence and –173 G/C genotype of the MIF gene was statistically significant. Individuals with the CC genotype seem to be predisposed to FMF. Conclusion The C/C polymorphism at position –173 of the MIF gene could be associated with excessive inflammation and immune response and can lead to susceptibility to FMF

Giriş: Zehirlenmeler çocukluk çağı acil hastalıklar arasında morbidite ve mortalitenin önlenebilir nedenleri arasında yer alır. Bu çalışmada Tokat ili ve çevresinde görülen çocukluk çağı zehirlenmelerinin epidemiyolojik özelliklerini belirlemeyi amaçladık. Yöntemler: Gaziosmanpaşa Üniversitesi Tıp Fakültesi çocuk yoğun bakım ünitesine 01/02/2014 ile 30/06/2016 tarihleri arasında yatan 148 zehirlenme olgusu geriye dönük olarak değerlendirildi. Bulgular: Çocuk Yoğun Bakım Ünitesinde yatırılarak izlenen olguların %50.3’ü kız, %49.7’i erkek idi. Zehirlenmelerin en sık görüldüğü yaş grubu 2-5 yaş olup (%40,1), bu dönemde en sık görülen zehirlenme etkeni ise farmakolojik ajanlardı. Zehirlenme etkenlerinin %74.8’i farmakolojik ajanlardı. Zehirlenme olgularının 45’i (%30,6) intihar amaçlı, 88’i (% 59.9) kaza sonucu meydana gelmişti. Mevsime göre dağılımda hastaların %25.2’i sonbahar, %22.4’i yaz ,%17.7’si kış, %34.7’si ilkbaharda başvurmuştu. Çalışmanın yapıldığı dönemde uygun takip ve destek tedavisi ile olguların hiçbirinde ölüm gözlenmedi. Sonuç: Bölgemizin zehirlenme profilinin belirlenmesinin, koruyucu önlemlerin alınmasına katkısı olabileceğini ve eğitim i,le zehirlenme oranlarının düşürülebileceğini düşünmekteyiz. &nbsp

WOS:000352133100002 PubMed: 25615955 Background: In this study we investigated the potential of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), and red cell width distribution (RDW) as new inflammatory markers to identify chronic inflammations during symptom-free periods in children diagnosed with Familial Mediterranean Fever (FMF). Material/Methods: The study included 153 children diagnosed with FMF based on the Tel-Hashomer Criteria, and 90 healthy volunteers. Hospital records were obtained to collect NLR, PLR, MPV, RDW, and FMF scores and the FMF mutation analyses of the patients enrolled in the study. Data on proteinuria were also collected and defined as a protein/creatinine ratio >0.2. Results: NLR, PLR, MPV, and RDW were significantly higher in symptom-free FMF patients than in the control group. C-reactive protein values also weakly correlated with NLR, PLR, MPV, and RDW, but the correlation was not statistically significant. NLR had the strongest correlation with CRP. The NLR cut-off point to indicate subclinical inflammation in symptom-free FMF patients was calculated to be 1.65. Conclusions: NLR, PLR, MPV, and RDW are potential subclinical inflammation markers in patients with FMF. NLR, PLR, MPV, and RDW values are higher in patients with FMF during symptom-free periods. NLR was found to be the most reliable marker for subclinical inflammation when compared to PLR, MPV, and RDW. We also found that these markers are not significantly higher in proteinuric patients when compared with levels in non-proteinuric patients.

Amaç: Bölgemizdeki çocuklarda idrar yolları enfeksiyonlarında sık rastlanan mikroorganizmalar, bunların antibiyotik duyarlılığı ve direnç paternlerinin saptanması ve bulgularımıza göre bölgemiz için ampirik antibiyotik seçeneklerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Ocak 2005 ve Haziran 2008 tarihleri arasında Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Pediatri AD poliklinikleri ve servisinde idrar yolu enfeksiyonu tanısı ile takip ve tedavi edilen çocuk hastaların idrar kültürü sonuçları geriye dönük olarak değerlendirildi. Bulgular: Altmış (%25) erkek, 183 (%75) kız toplam 243 çocuk hastadan 301 idrar kültüründen izole edilen mikroorganizmalar değerlendirmeye alındı. En çok izole edilen mikroorganizma %74,8 ile E. Coli'dir. Klebsiella spp. % 11,3, enterobacter spp. % 2,4, proteus %1 ve gram pozitifler %5 ile E. Coli'yi takip etmişlerdir En sık izole edilen E. Coli'nin antibiyotik dirençleri ise ampisilin %69,3, trimetoprim sülfometaksazol (Tmp+Smx) %54,8 ve amikasin %3,2 olarak bulundu. İkinci sırada üretilen klebsiella spp. de ise dirençler ampisilin %95,2, Tmp+Sxm %40,9 ve amikasin %1 olarak bulundu. Sonuç: Yıllar içinde ampisilin ve Tmp+Smx direnci giderek artmıştır. Gereksiz, uygun olmayan ve düzensiz ilaç kullanımı ile diğer antibiyotiklere direnç gelişimi de beklenebilir. Yaygın rehberlerdeki öneriler dikkate alınarak bölgesel bakteri duyarlılıklarına göre antibiyotik tercih edilerek direnç gelişimi önlenebilir.

Purpose: We aimed to evaluate the possible risk factors for the development of retinopathy of prematurity(ROP) Patients and Methods: A retrospective study was conducted between January 2012- and May 2013 for premature infants aged 34 weeks or younger who were screened for premature retinopathy. Fifty nine infants were included into the study. Birth weight, gestational age and other risk factors were evaluated.. Results: Birth weights were between 750 and 3590g (mean 1960g) gestational ages between 24 and 34weeks (mean 31.9w). ROP with various stages was observed in 7 (%11.8) patients. Birth weight and gestational age were found to be inversely related to the presence of ROP. Continuous positive airway pressure, blood transfusions were directly related to the development of ROP . Conclusion: Increased survival rate of low gestational age and low birth weights infants with better standards in neonatal intensive care units, the incidence of ROP. Efficient screening and treatment must be used to prevent the permanent visual loss associated with ROP [J Contemp Med 2013; 3(3.000): 161-165]

WOS:000393323800004 PubMed: 28123331 Aim: Hypercalciuria is an important cause of urinary tract symptoms, and also frequently results in urolithiasis. Urinary calcium excretion varies for geographic areas. We aimed to assess percentiles of urinary calcium excretion and prevalence of hypercalciuria for school-aged children in Tokat (city located in inner northern region of Turkey). Material and Methods: One thousand three hundred seventy-five children aged 6 to 18 years were enrolled in the study. Urine samples were obtained randomly. The children's variables as sex, age, length, and weight were recorded. Urinary calcium and creatinine determined from the urine samples and urinary calcium/creatinine ratios (mg/mg) were calculated. Percentiles of urinary calcium/creatinine ratios were also assessed for each age of the children. Results: Six hundred eighty-three of the 1 375 children were girls and 692 were boys. The mean age of the children was 11.68 +/- 3.43 years. Some 23.9% of the children were living in rural regions and 76.1% were were living in urban regions. The mean urinary calcium/creatinine ratio was 0.080 +/- 0.24 and the 95th percentile value of the urinary calcium/creatinine ratio was 0.278. The hypercalciuria prevalence for school-aged children was 4.7% when the urinary calcium/creatinine ratio value for hypercalciuria was accepted as >= 0.21. The prevalence of hypercalciuria in rural and urban regions was 7.60% and 3.82%, respectively (p0.05). Conclusion: The prevalence of hypercalciuria and urinary calcium excretion vary for different geographic areas, not only for countries. The percentiles of urinary calcium excretion should be assesed for every geographic region and the prevalance of hypercalciuria should be determined with these values. There is controversy as to whether obesity is a risk factor for hypercalciuria.

Kırım Kongo Hemorajik Ateşi (KKHA) çocukluk çağında fatal seyirli kene tutunması sonucu ortaya çıkan klinik tablodur. Çok çeşitli klinik ve laboratuvar bulguları ile karşımıza çıkabilir. Bu yazıda atipik bir prezentasyon olan hiponatremi ve bilinç bulanıklığı ile başvuran olgu sunulmuştur. KKHA'nde hiponatremi daha önce bildirilmemiştir.Olguda 4 yaşında kız hasta ateş, halsizlik ve hiponatremiye bağlı bilinç bulanıklığı ile başvurdu. Hastanın kırsal kesimden başvuruyor olması ve Tokat yöresinde KKHA vakalarının çok sayıda olmasından dolayı KKHA virüsü enfeksiyonundan şüphelenildi. KKHA virüsüne karşı IgM antikorlarının ve Real-Time PCR ile virüsün saptanması ile tanı doğrulandı.Bu vakayı daha önce KKHA vakalarında elektrolit dengesizliğinin bildirilmemiş olması ve hiponatreminin neden olabileceği bilinç bulanıklığı ve konvülziyon gibi klinik tablolarla karşılaşılabileceğini vurgulanmak amacıyla sunduk Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal systemic disease in children caused by a tick- borne virus. Many different clinical and laboratory findings are seen in CCHF. We report here an atypical presentation of CCHF with hyponatremia. CCHF with electrolyte imbalance is not reported before.A 4-year-old girl presented with fever, fatigue and unconsciousness with hyponatremia.Based on the clinical and epidemiological findings, virus infection was suspected. Hyponatremia is has never been reported in CrimeanCongo hemorrhagic fever (CCHF), as was observed in this case.The diagnosis was confirmed by detection of IgM antibody to CCHF virus and positive Real-Time PCR. We report the first case of imported CCHF presenting as hyponatremia. This electrolyte imbalance has never been reported before in CCHF in children, and the clinician should consider this entity in complications to explain unconsciousness

Akondroplazi çocuklarda en sık görülen iskelet displazisidir. Akondroplazik hastalarda üst solunum yollarının obstrüksiyonu ve kraniyofasiyal dismorfoloji nedeniyle solunum yolu yakınmaları sık görülmektedir. Bu hastalarda özellikle geceleri gelişen kronik hipoksemi pulmoner hipertansiyona yol açabilmektedir. Bu makalede ciddi gün içinde de devam eden pulmoner hipertansiyon gelişen akondroplazik bir çocuk sunulmuştur.

The definition of childhood metabolic syndrome has not been described clearly. Childhood obesity is increasing gradually, and the incidence of childhood metabolic syndrome is also rising. We aimed to show metabolic syndrome components and preventive factors for metabolic syndrome in obese children Methods: In the present study, 187 obese children and adolescents 5-18 years old were investigated retrospectively. Demographic data, anthropometric measurements, body mass index, blood pressure values, insulin levels, oral glucose tolerance test results, total cholesterol, high density lipoprotein, and triglyceride levels were obtained from hospital records. A body mass index95th percentile was considered obese. Insulin resistance was calculated according to the oral glucose tolerance test with 1.75 g/kg glucose maximum 75 g glucose. The insulin sensitivity index and homeostatic model assessment-insulin resistance (HOMA IR) were calculated and compared. Metabolic syndrome was diagnosed according to the modified WHO criteria adapted for metabolic syndrome in children.Abnormal glucose homeostasis was detected in 53% of subjects. Dyslipidaemia was present in 45.7% and hypertension in 16.6% of the patients. Metabolic syndrome was identified in 24.6% of obese children and adolescents. High HOMA-IR values and fasting glucose levels, elevated triglycerides and lower HDL levels were an indication of metabolic syndrome.Obesity and insulin resistance are significant factors for the development of metabolic syndrome in children and adolescents. In obese children higher HDL levels are preventive factor for metabolic syndrome. Preventing obesity and insulin resistance may decrease the prevalence of metabolic syndrome.Objetivo: El síndrome metabólico infantil no ha sido definido aún con claridad. La obesidad infantil se está incrementando progresivamente al igual que la incidencia del síndrome metabólico infantil. Nuestro objetivo ha sido mostrar los componentes del síndrome metabólico y sus factores preventivos en los niños obesos. Metodología: Este estudio analizó de forma retrospectiva a 187 niños y adolescentes obesos de entre 5 y 18 años. Los datos demográficos, las medidas antropomórficas, los índices de masa corporal, los valores de presión sanguínea, los niveles de insulina, los resultados de test de tolerancia a la glucosa oral, el total de colesterol, las lipoproteínas de gran densidad y los niveles de triglicéridos fueron obtenidos de registros hospitalarios. Una masa corporal con un índice superior a 95 percentiles fue considerada como obesidad. La resistencia a la insulina se calculó de acuerdo con el test de tolerancia a la glucosa oral con 1,75 g/kg de glucosa y un máximo de 75 gramos de glucosa. Se calculó y comparó el índice de sensibilidad a la insulina y la evaluación del modelos homeostático- resistencia a la insulina (HOMA IR). El síndrome metabólico fue diagnosticado de acuerdo con los nuevos criterios de la OMS adaptados a los síndromes metabólicos infantiles. Resultados: Se observó una homeostasis de glucosa anormal en el 53% de los casos. La dislipidemia estaba presente en el 45,7% de los pacientes y la hipertensión en un 16,6%. El síndrome metabólico fue identificado en un 24,6% de los niños y adolescentes obesos. Altos valores de HOMA-IR y de glucosa, triglicéridos elevados y niveles bajos de HDL eran indicadores de síndrome metabólico. Conclusión: La obesidad y la resistencia a la insulina son factores significativos para el desarrollo del síndrome metabólico en niños y adolescentes. En niños obesos altos niveles de HDL son un factor preventivo del síndrome metabólico. Prevenir la obesidad y la resistencia a la insulina puede reducir el predominio del síndrome metabólico.

Günümüzde tüberküloz yılda iki milyon kişinin ölümüne neden olmaktadır. Çocuk yaş grubunda yıllık sıklığı yaklaşık 1,3 milyon olup, ölümle sonuçlanan olgu sayısının 450 000 olduğu tahmin edilmektedir. Dünya Sağlık Örgütü, olguların %15-25’inin akciğer dışı tüberküloz hastaları olduğunu bildirmektedir. Burada immün yetersizliği olmayan, iki taraflı psoas apsesi ve ingüinal lenf bezi tutulumu ile giden nadir bir tüberküloz olgusu sunulmaktadır. Tuberculosis as an important health problem of our age causing death of 2 million people each year. The incidence of tuberculosis in the pediatric age group is 1.3 millions/year and it's estimated that 450 000 cases result in death. WHO reports that %15-25 of cases are extrapulmonary tuberculosis patients. Here we present a rare case of abdominal tuberculosis who had no immunsupression with isolated bilateral psoas abscess and inguinal lymph node involvement.

Purpose: We aimed to evaluate the possible risk factors for the development of retinopathy of prematurity(ROP) Patients and Methods: A retrospective study was conducted between January 2012- and May 2013 for premature infants aged 34 weeks or younger who were screened for premature retinopathy. Fifty nine infants were included into the study. Birth weight, gestational age and other risk factors were evaluated.. Results: Birth weights were between 750 and 3590g (mean 1960g) gestational ages between 24 and 34weeks (mean 31.9w). ROP with various stages was observed in 7 (%11.8) patients. Birth weight and gestational age were found to be inversely related to the presence of ROP. Continuous positive airway pressure, blood transfusions were directly related to the development of ROP . Conclusion: Increased survival rate of low gestational age and low birth weights infants with better standards in neonatal intensive care units, the incidence of ROP. Efficient screening and treatment must be used to prevent the permanent visual loss associated with ROP, Amaç: Prematürite retinopatisi (PR) gelişimi için muhtemel risk faktörlerini değerlendirmek amaçlandı Gereç ve Yöntem: Ocak 2012-Mayıs 2013 arasında 34.gestasyonel haftasında veya daha küçük olan prematüre bebekler retrospektif olarak değerlendirildi. 59 bebek çalışma kapsamına alındı. PR gelişimi ile doğum ağırlığı, gestasyonel yaş ve diğer risk faktörleri arasındaki ilişki araştırıldı. Bulgular: Olguların doğum ağırlıkları ise 750-3590gr (ortalama 1960gr) gestasyonel yaşları 24-34hafta(ortalama 31.9hafta) arasındaydı. Çeşitli evrelerde PR, 59 bebeğin 7sinde (%11.8)saptandı. Doğum ağırlığı ve gestasyonel yaş ile PR gelişimi açısından ters orantı tespit edildi. Sürekli pozitif havayolu basıncı ile oksijen kullanımı, kan transfüzyonu gibi risk faktörleri ile PR arasında istatistiksel olarak anlamlı bir ilişki bulundu. Sonuç: Yenidoğan ünitelerindeki koşulların iyileşmesi ile birlikte bebeklerin yaşam şanslarının artması PR görülme sıklığını arttırmaktadır. Prematür retinopatisinin neden olduğu kalıcı görme kayıplarının önlenmesi için etkin takip ve tedavinin yapılması gerekmektedir

Although arterial occlusions are relatively uncommon in newborns, the management of arterial occlusion in newborns is still controversial and there is a lack of consensus. We report a newborn infant with acute femoral occlusion at delivery. Conservative, medical treatment was chosen considering the prematurity of the baby and the high risks of bleeding associated with thrombolytic therapy. Six hours after initiation of medical therapy, the femoral blood flow was restored in Doppler ultrasonography. Arterial occlusions in the newborns are rare but challenging events. Sharing experiences may help clinicians in building a consensus on managing arterial occlusions.

Purpose: Vitamin D deficiency or insufficiency plays a role in the initiation and perpetuation of certain autoimmune diseases. The purpose of this study was to measure the vitamin D status of children with Familial Mediterranean Fever (FMF) and compare it to their healthy peers. Methods: A total of 50 FMF patients and 49 healthy children were enrolled in this prospective study. Vitamin D levels were measured via HPLC. Demographic data, FMF symptom severity scores and the levels of other disease activity markers were retrieved from our hospital database. Results: The mean age and gender balance of patients and controls were similar, being 8.4±3.8 years and 19 male patients, and 9.1±3.0 years and 25 male controls, respectively. The mean 25(-OH) vitamin D3 levels were 15.94±9.66 µg/L in FMF patients and 41.22±21.31 µg/L in controls. Vitamin D levels were normal in 12% of FMF patients, insufficient in 62% and deficient in 26%. No vitamin D deficiency was evident in any control subject; 30% had insufficient and 70% had normal vitamin D levels. Plasma vitamin D3 levels were similar in all patients despite varying FMF symptom severity scores. Conclusions: Vitamin D deficiency is frequent in children with FMF but is not associated with disease severity score.