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Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University 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 Pamukkale Medical Journal is the property of Pamukkale Journal 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.)

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University 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.)

Aim: Vesicoureteral reflux (VUR) is an important risk factor for urinary tract infection (UTI). We aimed to investigate the relationships between VUR and ultrasound with late dimercaptosuccinic acid (DMSA) scan findings in children aged older than two years who had their first febrile UTI (FUTI). Materials and Methods: Data from those patients with their first FUTI were retrospectively analyzed. A late DMSA scan was performed at least 6 months after an acute FUTI. The late DMSA scans were graded as mild (focal defect in uptake), moderate (uptake of renal radionuclide from 20 to 40%), and severe (shrunken kidney with uptake less than 20%). Micturating cystourethrography was performed at 3 to 6 weeks after the FUTI. Results: The records of 220 patients (61 mild VUR, 60 severe VUR, 99 without VUR) were reviewed. An abnormal US was more common in those patients with VUR than those without VUR (p=0.009). Abnormal US had a sensitivity of 79.34% for VUR and 81.67% for severe VUR. The negative predictive value of renal US for severe VUR was 91.13%. The frequency of renal scarring was higher in those patients with VUR than for those without VUR (102/44, p=0.001). A logistic regression analysis showed significant associations between abnormal US and VUR or severe VUR (p=0.019 and p=0.011, respectively). Renal scarring had a sensitivity of 84.3% for VUR, and 91.67% for severe VUR. Conclusion: Late DMSA scan findings can predict the presence and grade of VUR in older children who have their first FUTI. Normal renal US can predict the absence of severe VUR. [ABSTRACT FROM AUTHOR]

Introduction: The patients with non-dipper hypertension have an increased risk for target organ damage because of inflammation and platelet activation. In this study, we aimed to investigate the association between ambulatory blood pressure monitoring (ABPM) values and inflammation with platelet indices in children with dipper and non-dipper hypertension.Materials and Methods: A total of 153 patients who underwent ABPM were included in this retrospective study. The participants were divided into three groups (61 non-dipper hypertensive, 28 dipper hypertensive, 64 normotensive). Neutrophil and platelet count, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) were matched data among groups.Results: The neutrophil counts were higher in the non-dipper and dipper groups compared with the normotensive group (P < .05, P < .05, respectively). Also, MPV levels were significantly higher in the non-dipper and dipper groups than in normotensive group (P < .05, P < .05, respectively). Logistic regression analysis showed significant association between non-dipper status and MPV with platelet count (P < .05, P < .05, respectively). The abilities of MPV and platelet count to predict the non-dipper status were determined by receiver operating characteristic curve analysis (areas under the curve were 0.709 and 0.604, respectively).Conclusions: The higher MPV and neutrophil count may be potential indicators of increased risk for the development of hypertension in children. In addition, MPV and platelet count may help to determine the presence of non-dipper status in children with hypertension. [ABSTRACT FROM AUTHOR]

Amaç: Miyokardit erişkin Stili hastalığında çok nadir görülen ve fatal seyredebilen bir komplikasyondur. Sıklıkla makrofaj ak-tivasyon sendromu (MAS) gelişen Stili hastalarında bildirilmiştir. Burada sistemik jüvenil idiyopatik artrit (JIA) tanısı ile takip edilen, izlemde MAS ile birlikte akut miyokardit gelişen bir olgu sunulmuştur. Olgu: Sistemik JIA tanısı ile 8 yıldır takip edilen 11 yaşındaki erkek hasta 5 gündür devam eden ateş, döküntü, sağ ayak bileğinde şişlik ve hareket kısıtlılığı yakınmalarıyla hastanemize başvurdu. Fizik muayenesinde ateşi 38.5 °C, kalp tepe atımı 127/dk, kan basıncı 110/70 mm Hg idi, tüm gövdede ve alt aks-tremitelerde yaygın makülopapüler döküntü, sağ ayak bileğinde artriti vardı. Laboratuvar değerlendirmesinde; Hb:11.6 g/dl, WBC: 11.300/ mm3, ANS: 10.500, PLT:190.000/mm3 eritrosit sedimentasyon hızı 28 mm/sa, CRP: 129.2 g/dl, Fibrinojen: 445.4 mg/dl, LDH: 442 U/L, Ferritin: 9111 ng/ml, trigliserit 302 mg/dl bulundu. İzlemde lökopeni, trombositopeni, anemide derinleşme, ferritin düzeyinde artış ve fibrinojende de düşme saptandı. Kemik iliği incelemesinde hemofagositoz görülen hastaya sistemik JIA'ya ikincil MAS tanısı kondu. İzlemde genel durumunda kötüleşme, kan basıncında (55/35-75/50 mmHg) düşme, kapiller dolum zamanında uzama gelişti. Ekokardiogra-fisinde ejeksiyon fraksiyonu %45, sol ventrikül kontraksiyonla-rında yetersizlik, hafif mitral yetersizlik, hafif triküspit yetmezliği, hafif pulmoner yetmezhk, perikardiyal sıvı saptandı. Hastaya MAS ve akut miyokardit tanısı konularak pulse streoid ve plazmaferez tedavisi uygulandı. Miyokarditi kontrol altına alınamayan hastaya anakinra 80 mg/gün başlandı. Anakinra tedavisinin 1. haftasında klinik ve laboratuvar bulgulan düzelen hastanın EKO'sunda ejeksiyon fraksiyonu %70'e çıktı. Sonuç: Akut miyokardit, erişkin Stili hastalığında çok nadir görülen bir komplikasyon olarak bildirilmekle birlikte literatürde akut miyokardit gelişen çocukluk çağı sistemik JİA'lı hastalara dair hiç olgu yoktur. Bu olgunun sistemik JIA tanısı ile izlenen bir hastanın takiplerinde MAS ve akut miyokardit gelişebileceğine dikkat çekmesi ve anakinra ile başarılı bir şekilde tedavi edilmesi nedeni ile önemli olduğu ve literatüre katkı sağlayacağı düşünülmektedir. [ABSTRACT FROM AUTHOR]