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We have evaluated urinary tract infections (UTI) in neonatal indirect hyperbilirubinemia. Urine culture is not routinely requested in patients with indirect hyperbilirubinemia. However, debates continue about the frequency and investigation of UTI in neonatal indirect hyperbilirubinemia patients. The aim of this study was to determine the prevalence of UTI in neonates admitted to the hospital due to pathological indirect hyperbilirubinemia and whether a routine urine culture test is necessary in patients.In this retrospective study, we analyzed data from 1390 patients hospitalized to the Neonatal Unit due to pathological indirect hyperbilirubinemia. One hundred and eleven of these patients with detected bacterial agents in the urine cultures were evaluated. The type of the pathogens grown in urine culture, the number of colonies, and the antibiotic resistance status were evaluated.Among 1390 patients screened, 111 (8%) were found to have UTI, 68 of whom (61.3%) were male. Out of the microorganisms that grew, Escherichia coli was the dominant microorganism with 36.1%, which was followed by Klebsiella species (23.4%), and Enterococcus species (18%), respectively.The prevalence of UTI is high in the neonatal period as in all childhood and especially in patients admitted to the Neonatal Unit due to indirect hyperbilirubinemia. Escherichia coli and Klebsiella species are the most common bacterial agents that grow. Missing the diagnosis of urinary tract infection in neonates may cause renal problems. Therefore, we recommend requesting a urine culture in routine examinations of neonates who are diagnosed with pathological indirect hyperbilirubinemia and admitted to the hospital due to the need for phototherapy.

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 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.

Although many pediatric studies on children infected with coronavirus disease 2019 (COVID-19) have been published, the diagnosis, clinical symptoms, laboratory findings, and treatment of COVID-19 in children are still unclear.This study was conducted with an aim to examine the hematological findings of symptomatic pediatric patients diagnosed with COVID-19 in May 2020 at the Pandemic Hospital in Dicle University. Patient records were evaluated retrospectively. This study involved 59 symptomatic pediatric patients with a definite diagnosis of COVID-19 who had positive SARS-CoV-2 RT-PCR test results on nasopharyngeal swab between March 15, 2020 and May 31, 2020.The records of a total of 10 (16.9%) patients under the age of 1; 21 (35.6%) patients aged 1-10 years, and, 28 (47.5%) patients aged 10-18 years, who had been diagnosed with COVID-19 were evaluated. Based on severity, 35 (59.3%) patients were in the mild group (group 1) and 24 (40.7%) patients were in the moderate-severe group (group 2). The blood parameters of WBC, neutrophil, lymphocyte, monocyte, and thrombocyte counts, the hemoglobin (Hgb) level, and NLR, PLR, MPV, fibrinogen, ferritin, and D-dimer levels were compared between groups, the difference was not statistically significant (P.05). LDH was higher in group 2 (P = .014).Since children infected with COVID-19 show mild clinical symptoms or are asymptomatic, fewer pediatric patients may be detected than adults. Therefore, it should be known that the laboratory findings typical for adults may not accompany the disease in pediatric cases. More studies are needed to determine the most appropriate COVID-19 treatment approach for children, as hospitalization history and testing rates are less reported among children.

Platelet parameters such as platelet count (PLT), mean platelet volume (MPV) and platelet mass index (PMI) are associated with physiological and pathological functions in various inflammatory diseases. The aim of the present study was to investigate whether platelet parameters were related to retinopath y of prematurity (ROP) in premature newborns. We retrospectively evaluated the platelet count, platelet mass index, and MPV parameters measured on the first day and 28th day, which belonged to patients, who were examined for retinopathy of prematurity at n eonatal intensive care unit. Among 343 patients enrolled by the study, 52.8 % (181) were male and 47.2 %(162) were female. The PLT level studied on the first day was 231.6±84(x1000/mm3) in the ROP group and 207.8±81.6(x1000/mm3) in the non ROP group, and t he PLT level studied on the 28th day was 409.9±179.4(x1000/mm3) in the ROP group and 350.7±140.4(x1000/mm3) in the non ROP group. There was a significant difference between the two groups regarding both PLT levels (p=0.007, p=0.006, respectively). The PMI level studied on the first day was 1854.1±774.7 in the ROP group and 1638.2±753.3 in the non ROP group, and the PMI level studied on the 28th day was 3784.5±1797.4 in the ROP group and 3302.8±1452.9 in the non ROP group. This study showed that platelet count and platelet mass index measured on the first and 28th days are important parameters in patients who undergo ROP examination, and these parameters measured prior to examination will guide clinicians in diagnostic process.

Background: The pandemic of the new coronavirus disease (COVID-19) continues to be a major health problem globally. In this study, clinical findings, radiological findings, laboratory findings and polymerase chain reaction (PCR) test results were evaluated according to age groups in pediatric patients with COVID-19. Methods: In this study, PCR (+) and PCR (-) 278 cases diagnosed with COVID-19 between March 15, 2020 and September 30, 2020 were assessed considering clinical symptoms, radiological and laboratory findings and RT-PCR test results. Results: 43.9% of the cases consisted of RT-PCR (+) and 56.1% of RT-PCR (-) cases. Fever was observed at the rate of 64.7%, cough 53.2%, respiratory distress 12.2%, myalgia 24.5%, diarrhea 12.9%, chest X-ray findings 48.2% and computed tomography findings 43.6%. Diarrhea and cough, alanine aminotransferase, aspartate aminotransferase, leukocyte and lymphocyte elevation were determined as significantly higher in younger age group cases, while high myalgia and neutrophilia was observed in older age group children (p

PMID: 33819976 Background/aim: Postnatal corticosteroids are commonly used to treat bronchopulmonary dysplasia (BPD). We aimed to show whether S100 calcium-binding B (S100B), neuron-specific enolase (NSE), Tau protein or microtubule-associated protein tau (MAPT), and glial fibrillary acid protein (GFAP) levels would provide any evidence of early neurological damage in premature infants receiving postnatal low dose dexamethasone therapy for BPD treatment. Materials and methods: In this cohort study, 136 preterm infants diagnosed with BPD at ≤32 weeks of gestation formed the study group, and 64 preterm infants formed the control group. NSE, S100B, GFAP, and MAPT levels were first measured before the postnatal corticosteroid treatment in both the patient and the control group on the 28th day and, for a second time, after treatment termination in the patient group. Results: There were significant differences between the measured GFAP, MAPT, and NSE values of the BPD and control groups on the 28th day, whereas there was no significant difference between the measured S100B values of the two groups. There were a statistically significant difference between the NSE values measured on the 28th day and after the treatment within the BPD group, whereas no significant difference existed between the GFAP, MAPT, and S100B values. Conclusion: NSE levels, which indicate brain damage in the early period, increased in preterm babies with BPD who had been administered postnatal dexamethasone.

Objectives Amniotic band syndrome and osteogenesis imperfecta are two distinct diseases that develop due to structural defects of the collagen protein. In our paper, we report the concurrence of these two diseases rarely seen in the newborn period. Case presentation A female infant born at 33rd gestational week was found to have constrictive bands in her right lower extremity and flexion contractures in distal joints of lower and upper extremities due to amniotic bands in postnatal physical examination. While being treated for respiratory difficulty, she was diagnosed with osteogenesis imperfecta and treated with bisphosphonates upon being found to suffer bilateral humeral fractures on the sixth day of life. She received respiratory support with mechanical ventilation due to respiratory tract complications related to osteogenesis imperfecta and died on the 384th day of life. Conclusions One should bear in mind that other collagen tissue diseases may accompany the amniotic band syndrome; this possibility should be definitely pursued if clinical suspicion exists.

WOS:000575612200001 PMID: 32991038 Background The novel coronavirus disease (Covid-19) can progress with mild to moderate or self-limiting clinical findings in children. The aim of this study was to investigate the disease features of Covid-19 in Turkish children. Methods Children diagnosed by the method of real-time reverse transcription-polymerase chain reaction for Covid-19 at the Dicle University Department of Pediatric, between April and June 2020, were evaluated. Hospital records were investigated retrospectively. Results One hundred and five patients children with the mean age of 108.64 +/- 65.61 months were enrolled in this study. The most common cause of transmission in pediatric patients was in contact with a family member diagnosed with COVID-19 (n = 91, 86.7%). The most common admission complaints were dry cough (n = 17, 16.2%), fever (n = 16, 15.2%), lassitude and fatigue (n = 14, 13.3%) respectively. More than 95% of all children with Covid-19 were asymptomatic, mild, or moderate cases. CRP was identified only independent factor associated with long duration of hospitalization. Conclusion The results of this study show the effect of Covid-19 on Turkish children. A clear understanding of the local epidemiology of corona virus infections and identification of risk factors are critical for the successful implementation of the prevention and control program.

Background: The novel coronavirus disease (Covid-19) can progress with mild to moderate or self-limiting clinical findings in children. The aim of this study was to investigate the disease features of Covid-19 in Turkish children. Methods: Children diagnosed by the method of RT-PCR for Covid-19 at the Dicle University Department of Pediatric, between April and June 2020, were evaluated. Hospital records were investigated retrospectively. Results: One hundred and five patients children with the mean age of 108.64±65.61 were enrolled in this study. The most common cause of transmission in pediatric patients was contacting with a family member diagnosed with COVID-19 (n=91, 86.7%).The most common admission complaints were dry cough (n=17, 16.2%), fever (n=16, 15.2%), lassitude and fatigue (n=14, 13.3%) respectively. More than 95 % of all children with Covid-19 had asymptomatic, mild, or moderate cases. CRP was identified only independent factor associated with long duration of hospitalization. Conclusion: The results of this study show preliminary results of a study investigating the effect of Covid-19 on Turkish children. A clear understanding of the local epidemiology of corona virus infections and identification of risk factors is critical for the successful implementation of the prevention and control program.

BACKGROUND The aim of this study was to investigate the urine levels of human kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with iron-deficiency anemia (IDA). MATERIAL AND METHODS Thirty-five children with IDA and 32 matched healthy controls were recruited. We assessed complete blood count, serum iron, iron-binding capacity, ferritin, serum levels of urea, creatinine (Cr), sodium (Na), potassium (K), calcium (Ca), and glucose levels. Estimated glomerular filtration rate (eGFR) was calculated. Urinary NAG, NGAL, KIM-1, and L-FABP were measured and divided by urine creatinine for comparisons. RESULTS There were no significant differences in serum urea, Cr, or eGFR between the IDA group and the control group (p>0.05, for all). IDA patients had significantly higher urine NGAL/Cr, L-FABP/Cr, KIM-1/Cr, and NAG/Cr compared with the control group (p

Background: We aimed to determine the demographic and clinical features of patients with Beh cet’s disease (BD) in Southeastern Turkey. Methods: In this study, files of 132 patients with BD (76 females and 56 males) who were diagnosed with BD according to the International Study Group criteria at the Department of Dermatology of Dicle University Faculty of Medicine from 2005 to 2009 were evaluated retrospectively. Demographical and clinical characteristics of the cases were recorded . Results: Mean age of the cases was 32.40 ± 9.4 years (range 15 - 59 years) and male/female ratio was 0.73. The mean age at diagnosis was 28.71 ± 9.1 years. Six cases were diagnosed as juvenile BD (4.45%). Oral aphthous lesions (100%) and genital ulcers (94%) were found to be the most common findings of the disease, followed by pathergy positivity (75%), papulopustular lesions (74.2%), erythema nodosum (43.2%), thrombophlebitis (6.8%) and extragenital ulcers (6.1%). Systemic involvement was noted as joint involvement in 79.5%, ocular involvement in 28.8%, vascular involvement in 9.8%, pulmonary involvement in 2.3%, neurologic involvement in 2.3% and genitourinary system involvement in 0.8%. There was no significant difference between mucocutaneous findings and systemic involvement ratios of male and female cases. Conclusion: D emographic and clinical features of BD may vary according to geographical region, gender and ethnicity. We hope that this study will contribute to the epidemiologic data of BD which may exhibit different clinical and demographic features in different parts of the world. J Clin Med Res. 2014;6(6):476-481 doi: http://dx.doi.org/10.14740/jocmr1952w

The aim of this study was to determine the Mediterranean fever (MEFV) gene mutations and their clinical correlations in children with familial Mediterranean fever (FMF) in southeast Turkey. Clinical and laboratory characteristics of 147 (65 males, 82 females) consecutive children with FMF having a positive MEFV gene mutation were prospectively investigated. Patients with negative MEFV gene mutations or atypical FMF presentations and those from other regions of the country were excluded. Clinical manifestations and disease severity scores were recorded. The six most frequent MEFV mutations including M694V, V726A, R726H, P369S, E148Q and P369S were investigated by a reverse hybridization test method. The median age of study group was 9.0 years, median age at diagnosis was 7.8 years, median age at disease onset was 5.0 years, and median follow-up duration was 4.0 years. A positive family history of FMF and parent-to-offspring transmission was found in 58.5 and 42.2 % of families, respectively. The frequencies of independent alleles, with decreasing order, were E148Q (30.7 %), M694V (26.0 %), R761H (13.5 %), V726A (13.0 %), P369S (10.5 %) and M680I (6.3 %) in FMF patients. The M694V subgroup had higher mean disease severity score and longer attack duration compared with E148Q and other mutations subgroups (p < 0.05). Two patients with amyloidosis had the M694V homozygote genotype. In conclusion contrast to other regions and many other ethnicities of the world, the most frequent MEFV gene mutation was E148Q in southeast Turkey. The M694V mutation frequency was lower, and disease severity was relatively mild in FMF children of this region.

Objective: Burn wound infections are the most severe cause of mortality in patients in the burn units. The aim of this study is to determine the bacteriological profile and their antibiotic resistance patterns in burn unit of Dicle University Hospital. Methods: Medical records of 151 burn patients admitted to the burn unit of Dicle University Hospital between June, 2008 and June 2010 were reviewed retrospectively. Results: Our study included 70.2% (n=106) male and 29.8% (n=45) female patients. The mean age of cases was 10.9±14.7 years. The rate of isolated microorganisms were 62.3% (n=94) Acinetobacter baumannii, 25.8% (n=39) Pseudomonas aeruginosa, 7.3% (n=11) Escherichia coli and 4.6% (n=7) Staphylococcus aureus. The most effective antibiotic against A. baumannii was colistin (95%) followed by levofloxacin (84%) and trimethoprimsulfamethoxazole (87%). The most effective antibiotics against P. aeruginosa were amikacin (82%), ciprofloxacin (71%) and levofloxacin (71%). The most effective antibiotics against E. coli were amikacin (91%), meropenem (73%) and imipenem (82%). Conclusion: The prevalence of burn wound infection caused by A. baumannii and multiple drug resistant A. baumannii are increasing worldwide by time. The prevalence of multiple drug resistant P. aeruginosa and E. coli are rising also. So, new strategies of infection prevention should improve as soon as possible Amaç: Yanık yara enfeksiyonları yanık ünitelerindeki hastaların en sık ölüm nedenleridir. Amacımız Dicle Üniversitesi Hastanesi yanık ünitesindeki bakteri profilini ve antibiyotik direnç paternlerini belirlemekti. Yöntemler: Dicle Üniversitesi Hastanesi yanık ünitesinde Haziran 2008 ve Haziran 2010 tarihleri arasında yatarak takip edilen 151 hastanın dosyaları geriye dönük olarak incelendi. Bulgular: Çalışmamız 106 (%70,2) erkek ve 45 (%29,8) kadın hastadan oluşuyordu. Olguların yaş ortalaması 10.9±14.7 yıl olarak bulundu. İzole edilen mikroorganizmalar; %62,3 (n=94) Acinetobacter baumannii, %25,8 (n=39) Pseudomonas aeruginosa, %7,3 (n=11) Escherichia coli and %4,6 (n=7) Staphylococcus aureus olarak saptandı. A. baumannii’ye karşı en etkili antibiyotik kolistin idi, ikinci sırada levofloksasin (%84) ve üçüncü sırada trimethoprim-sülfametoksazol (%87) takip ediyordu. P. aeruginosa’ya karşı en etkili antibiyotikler; amikasin (%82), siprofloksasin (%71) ve levofloksasin (%71) idi. E. coli’ye karşı en etkili antibiyotikler ise amikasin (%91), meropenem (%73) ve imipenem (%82) idi. Sonuç: A. baumannii nedeniyle oluşan yanık yara enfeksiyonları ve çoklu ilaç direncine sahip A. baumannii’nin yaygınlığı dünyada giderek artmaktadır. Çoklu ilaç direncine sahip P. aeruginosa ve E. coli patojenleri de artmaktadır. Bu nedenle en kısa zamanda yeni enfeksiyon önleme stratejileri geliştirilmelidir

Objective: The aim of this study was to compare acutephase reactant (AFR) levels at attack period and attackfreeperiod under colchicine treatment in children with FamilialMediterranean Fever (FMF).Methods: The diagnosis of FMF was done based on clinicalcriteria and patients were prospectively followed upfor average of 1.2 years. Symptom-onset age, age at diagnosis,clinical symptoms and features of FMF attackswere recorded. MEFV gene mutations were detected byreverse hybridization (strip assay) method. Peripheralblood leukocyte count, erythrocyte sedimentation rate(ESR), C-reactive protein (CRP) and blood fibrinogen levelswere measured by standard methods, both at attackperiod and during attack-free period.Results: Totally 105 (55 girls, 50 boys) children with FMFwere included. The mean age was 8.9±3.2 years, meansymptom onset age was 5.9 years and mean age at diagnosiswas 8.1 years. MEFV gene mutations were asfollows: E148Q (29.2%), M694V (24.8%), R761H (15.3%)and V726A (13.1%). The mean AFR values were overnormal values in attack period and there was at least onehigh AFR level in 80.0% of patients. In attack-free period,although the mean values of all AFRs were within normallimits, 31.4% of patients had at least one high AFR level.Conclusion: Based on these data, one-third of FMF childrenhad a high AFR level, which may be a marker of subclinicalinflammation. In children with continuous inflammationduring attack-free period, a new anti-inflammatorydrug additional to colchicine can be considered in order toprevent complications of chronic inflammation. J Clin ExpInvest 2013; 4 (2): 213-218Key words: Familial Mediterranean Fever, acute phasereactants, children, attack period, attack-free period

Objective: Hyperbilirubinemia is a common problem of neonatal period that has high morbidity and mortality. Blood exchange is the most effective and urgent treatment modality for very high bilirubin levels that can lead to neurotoxicity called as kernicterus. The aim of this study was to compare 90 minutes exchange transfusion with that of 120 minutes. Methods: This study was performed at Dicle University Medical Faculty, Neonatal Unit between July 2007 and June 2008. A total of 36 term newborn (38 - 42 gestational week) without blood group incompatibility and with total serum bilirubin levels over 25 mg/dl were included. Newborns were randomly assigned in two groups each of them comprise 18 babies as Group 1 underwent 90 minute-exchange and Group 2 120 minute. Effectiveness and complications of exchange transfusion were recorded. Newborns with Rh, ABO or subgroup incompatibilities, prematurity or small for gestational age, septicemia, hypothyroidism, G6PD enzyme deficiency, intrauterine infections, diabetic mother\'s baby, hemolytic disease or metabolic diseases were excluded. Results: There were no significant differences in the body weight, gestational age, postnatal age, age of mother, total bilirubin and albumin levels, the number of blood exchange, hospital stay days and complications between two groups (p>0.05). However, mean phototherapy duration was significantly shorter in 120 minutes transfusion group compared with 90 minutes group (p, Amaç: Hiperbilirubinemi yenidoğan döneminde sık karşılaşılan, morbidite ve mortalitesi yüksek bir problemdir. Kan değişimi; kernikterus diye adlandırılan nörotoksisiteye yol açan yüksek bilirubin seviyeleri için en etkili ve acil tedavi yöntemidir. Bu çalışmada 90 dakika ve 120 dakika kan değişimin etkinliği ve komplikasyonlarının karşılaştırılması amaçlanmıştır. Yöntemler: Bu çalışmaya, Dicle Üniversitesi Tıp Fakültesi Yenidoğan Kliniği\'nde, Temmuz 2007-Haziran 2008 tarihleri arasında 36-42 gebelik haftasındaki, total serum bilirubin seviyeleri 25 mg/dl üzerinde olan ve kan grubu uyuşmazlığı bulunmayan 36 yenidoğan alındı. Onsekiz hastadan iki gruba rastgele olarak ayrılan hastalardan, 1. gruba 90 dakikada, 2. gruba ise 120 dakikada kan değişimi yapıldı. Tranfüzyonun etkinliği ve komplikasyonları kaydedildi. Rh, ABO ve subgrup uyuşmazlığı olan bebekler, gestasyonel yaşı küçük olanlar, sepsis, hipotiroidi, G6PD enzim eksikliği, intrauterin enfeksiyon, diabetik anne çocuğu, hemolitik yada metabolik hastalığı olanlar çalışmaya dahil edilmedi. Bulgular: Vücut ağırlığı, gestasyon yaşı, doğum sonrası yaşı, anne yaşı, total bilirubin ve albumin düzeyleri, kan değişim sayısı, hastanede kalma süresi ve komplikasyonlar açısından karşılaştırılan iki grup arasında belirgin bir fark saptanmadı. Ancak 120 dakika kan değişimi yapılan grupta fototerapi süresi belirgin şekilde daha kısaydı (p

We present a rare case of spontaneous closure of a fistula between the left coronary artery and the right ventricle (RV) within a few days of newborn period. A 14-day-old male newborn was referred to our clinic for investigation of tachypnea and cardiac murmur. A color flow Doppler echocardiography revealed turbulent flow of a large coronary artery fistula (CAF) between the left coronary artery and the RV. Tachypnea was regressed and repeat echocardiogram showed no CAF related to cardiac chambers after 4 days of admission. The spontaneous closure of CAF was found to be more likely in cases younger than 2 years with small-sized fistulas opening into the right-sided structures, especially into the RV. Nevertheless, the spontaneous closure is very rare in cases with significant shunt. To the best of our knowledge, this is the first case with documented spontaneous closure of CAF just within the newborn period.

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), aspar- tate 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

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.

Viral myositis associated with infections rarely may cause rhabdomyolysis. There is no any pediatric case with severe recurrent rhabdomyolysis triggered by infections in the literature. We reported a two-year-old boy who was hospitalized three times due to severe rhabdomyolysis associated with viral myositis in the winter months. This is the first child case presentation with severe rhabdomyolysis triggered by infections. Prednisolone and intravenous immunoglobulin treatments were ineffective in this case.La miositis viral asociada a infecciones raramente produce rabdomiólisis. En las publicaciones científicas no se describe ningún caso pediátrico de rabdomiólisis grave recurrente inducida por infecciones. En este artículo presentamos el caso de un niño de sexo masculino de dos años de edad hospitalizado en tres ocasiones debido a rabdomiólisis grave asociada a miositis viral durante el invierno. Esta es la primera presentación de un caso pediátrico de rabdomiólisis grave inducida por infecciones. En este paciente, el tratamiento con prednisolona e inmunoglobulinas por vía i.v. fue ineficaz.

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

Aim: Bronchial asthma is among the most common chronic pediatric diseases that can result in variable restriction in the physical, emotional and social aspects of the patient%u2019s life. The aim of this study was to assess impairment on quality of life (QOL) in asthmatic children. Material and Method: Ninety seven patients aged between 7 and 15 years which followed up at Pediatric Pulmonology Department of Dicle University Hospital were included into the study, during October 2009 %u2013 January 2010. To assess the quality of life Pediatric Asthma Quality of Life questionnaire%u2019s (PAQLQ) self-applied Turkish version was used. In addition, the severity of asthma was measured using by Childhood Asthma Control Test (C-ACT). Results: The male to female ratio of asthmatic children was 2/1 and the mean age was 10.0 %uF0B1 2.5 years. Severity of asthma, history of steroid use and low family income were found as having negative effect on the PAQLQ scores (p < 0.001). Mother%u2019s education level also had statistically significant effect on the PAQLQ scores (P = 0.02). Father%u2019s education level; patient%u2019s age, gender, passive smoking exposure, family history of asthma or eczema and duration of disease did not have statistically significant effect on PAQLQ scores (p>0.05). Asthma control test score had a significant correlation with PAQLQ score (p

Objectives: Due to involvement of various systems and clinical variety of in Henoch-Schönlein purpura (HSP), in this study, it was aimed to investigate clinical and laboratory features of children with HSP. Materials and methods: Hospital records of 214 children with HSP followed up between 2000 and 2007 at Dicle University Hospital Pediatrics Clinics were retrospectively evaluated. Diagnosis was made based on the HSP criteria of American College of Rheumatology. Age, gender, clinical findings, laboratory variables, applied treatments, and outcome were recorded. Results: Totally 214 HSP patients (121 male, 93 female) with the mean age of 9.0 ± 3.2 years (range, 2-16) were included. There was a history of upper respiratory tract infection in 136 children (63.6%). There was abdominal pain in 62.1% of patients, vomiting in 22.1%, and occult blood in stool or melena in 25.4%. Three patients underwent operation due to intusception. Joint involvement was seen in 117 (54.7%) and angioedema in 73 (34.3%) of patients. Renal involvement as hematuria was seen in 63 (29.4%) children, proteinuria in 57 (26.6%), leukocyturia (9.8%), and nephritic/nephritic proteinuria in five patients. Increased IgA and C3 levels were found in 35 (16.0%) and 41 (19.3%), respectively; and decreased C3 in 23 (10.7%). Benzathine penicillin and penicillin V were used in 114 (53.5%) of children, non-steroidal anti-inflammatory drugs in 128 (59.8%) and parenteral/oral corticosteroids in 86 (40.2%). Immonusuppressives were given to 5 patients with nephrotic proteinuria following renal biopsy. Conclusions: Gastrointestinal and renal involvement in children with HSP, rarely lead to major complications., Amaç: Henoch-Schönlein purpurası\'nın (HSP) çeşitli sistemleri tutması ve klinik seyrinin farklılık göstermesi nedeniyle, bu çalışmada HSP\'li çocukların klinik ve laboratuar özelliklerinin incelenmesi amaçlandı. Gereç ve yöntem: Dicle Üniversitesi Tıp Fakültesi Çocuk Kliniğinde 2000-2007 yılları arasında izlenen HSP\'li 214 çocuk hastaya ait hasta kayıtları geriye dönüşlü olarak incelendi. Hastalık tanısı American Collage of Rheumatology\' nin HSP kriterlerine dayanılarak kondu. Hastaların yaş, cinsiyet, klinik bulgular, laboratuar değişkenler, uygulanan tedavileri ve sonuçları kaydedildi. Bulgular: Toplam 214 HSP\'li çocuk hastanın (121 erkek, 93 kız) yaş ortalaması 9.0 ± 3.2 yıl (2-16 yaş arası) idi. Hastaların 136\'sında (%63.6) bir üst solunum yolu enfeksiyonu geçirme öyküsü mevcuttu. Hastaların %62.1\'inde karın ağrısı, %22.1\'inde kusma, %25.4\'ünde dışkıda gizli kan pozitifliği veya melena saptandı, üç hasta intusepsiyon nedeniyle opere edildi. Eklem tutulumu 117 (%54.7) hastada, anjiyo ödem 73 (%34.3) hastada görüldü. Renal tutulum bulgusu olarak 63 hastada (%29.4) hematüri, 57 hastada (%26.6) proteinüri, 21 hastada (%9.8) lökositüri gözlenirken, 5 hastada nefrotik/nefritik sendrom görüldü. IgA yüksekliği 35 (%16) olguda C3 yüksekliği 41 hastada (%19.3), C3 düşüklüğü 23 hastada (%10.7) rastlandı. Tedavi olarak 114 hastaya (%53.3) benzatin penisilin+ penisilin V, 128 hastaya (%59.8) non-steroidal antiinflamatuar, 86 hastaya (%40.2) oral/parenteral steroid verildi. Nefrotik proteinürisi olan 5 hastaya renal biyopsi sonrası immunsupresif verildi. Sonuç: Henoch-Schönlein purpurasında özellikle gastrointestinal sistem ve renal tutulum nadiren önemli komplikasyonlara yol açmaktadır.

BACKGROUND: Burn injuries are a huge public health issue for children. The aim of this study was to determine the demographic and etiological features, burn wound infections, and clinical trends of 2346 pediatric burns patients over 15 years in the southeast provinces of Turkey and to establish criteria for a pediatric burn prevention program. METHODS: Age, gender, degree of burn, demographics, etiology of burn, burn wound infections, length of hospital stay, total body surface area percentage, and outcome data of 2346 children (1064 males, 1282 females; mean age 4.42±3.56 years; range 2 months to 15 years) who admitted to the Burn Center of Dicle University between January 1994 and December 2008 were recorded. RESULTS: The male to female ratio was 0.8:1. The highest incidence appeared in the 0-4 years of age group (68.5%). Burn type was scalding burns in 1828 (77.9%), flame burns in 332 (14.2%) and electrical burns in 186 (7.9%). Distribution of the degree of burns was 19 (0.8%) first-degree, 2172 (92.6%) second-degree and 155 (6.6%) third-degree. The mean total body surface area burn was 21.5±12.6%. The mean length of hospitalization was 12.87±10.02 days. The most frequently isolated burn wound infections were Pseudomonas aeruginosa (52%, 368), Acinetobacter spp. (12%, 83), and Escherichia coli (9%, 66). 2241 (95.5%) cases were survivors and 105 (4.5%) were non-survivors. CONCLUSION: The epidemiological features of pediatric burns in the southeast region of Turkey differ from those of other regions. Burn prevention education should include training in pediatric burn prevention. Language: en

Scorpion sting envenomation is a life-threatening emergency and a common public health problem in many regions of the world, particularly in children. Children are at greater risk of developing severe cardiac, respiratory, and neurological complications.The aims of this study were to evaluate demographic, clinical, laboratory, treatment, and outcome characteristics for pediatric patients with scorpion sting envenomation in southeast Turkey and to describe features that may be predictive of the need for pediatric intensive care unit (PICU) care.A total of 52 charts of children (mean age: 7.7 +/- 2.8 years; age range: 1.5-15 years) presenting with scorpion sting envenomation to a single hospital in southeastern Turkey were investigated. General characteristics of the children, species of the scorpions, anatomic site of the sting, clinical and laboratory findings, treatment approaches, complications, and outcomes were recorded.Twenty-four stings (46.2%) were inflicted by Androctonus crassicauda, 1 (1.9%) by Leiurus quinquestriatus, and the sources of the other stings were not known. Thirty-one patients (59.6%) were admitted from rural areas. Admission from a rural area was a significant risk factor for severe envenomation. Foot-leg was the most frequently stung part of the body (48%). The greatest number of stings occurred in the summer (78.8%). Cold extremities and tachycardia were the most frequently seen clinical findings (38.4% for both). Twenty patients (38.5%) had signs of serious envenomation and required admission to the PICU. Hemoglobin, white blood cell count, activated prothrombin time, aspartate aminotransferase, alanine aminotransferase, and creatine phosphokinase levels were higher in severely envenomed children compared to levels in those with mild-moderate stings. Antivenom was given at a primary or secondary health center before arrival to our hospital in 44 (84.6%) patients, without any apparent difference in the number of patients presenting with mild-moderate and severe envenomed stings. All patients recovered after treatment except for 1 child who died with severe pulmonary edema.We found no clinically useful demographic or epidemiological data to guide decision making regarding the need for PICU admission for pediatric victims of scorpion sting in our area. Decisions on transfer and admission to a PICU should be based on the development of systemic findings of envenomation.

The aim of this study was to assess the role of oxidative stress in the pathogenesis of Henoch-Schönlein purpura (HSP) vasculitis. The activities of catalase (CAT), arylesterase (ARYL), and paraoxonase (PON) as antioxidant enzymes and serum malondialdehyde (MDA) level as an indicator of lipid peroxidation, together with total antioxidant status (TAS), were measured in 29 children with HSP (mean age 9.3 +/- 2.7 years), both at the onset of the disease and at the remission period and in matched controls. Active-stage HSP had significantly higher MDA level (15.5 +/- 7.3 vs 7.8 +/- 3.9 nmol/l, respectively, P0.001) and lower TAS (524 +/- 122 vs 699 +/- 122 mumol Trolox Equiv/l, P0.001), PON (97 +/- 47 vs 136 +/- 95 U/l, P = 0.042), ARYL (158 +/- 39 vs 212 +/- 52 U/l, P0.001), and CAT (50 +/- 27 vs 69 +/- 20 U/l, P = 0.002) activities compared with the control subjects. Although CAT (P0.05) and PON (P0.05) activities were found to be similar between active and remission stages of HSP, the active stage of the disease had significantly lower ARYL (P = 0.011) and TAS (P = 0.006) and higher MDA (P0.001) values compared with remission period. Significant positive correlations were found between CAT and MDA (r = 0.433, P = 0.019) and between CAT and C-reactive protein (r = 0.386, P = 0.035) in the active stage of HSP. No significant differences were detected in oxidant/antioxidant parameters between patients with or without renal, gastrointestinal, or joint involvement (P0.05). Increased oxidative stress and lipid peroxidation may play important roles in the pathogenesis of HSP vasculitis. Antioxidant therapeutic interventions in long-lasting vasculitis and risk of atherosclerosis secondary to increased oxidant stress remain to be investigated.

Leptin has a key role in energy homeostasis and there may be a link between leptin and insulin-like growth factor-1 (IGF-1) system. The aim of this study was to analyze the relationships between long-lasting insufficient caloric intake (marasmus), leptin and IGF-1 system.The study group consisted of 30 marasmic children and control group included 28 healthy children. After an overnight fasting; leptin, insulin, IGF-1 and IGFBP-3 levels were measured.Marasmic children had significantly lower body weight, height, mid-arm circumference (MAC), skinfold thickness, mean serum leptin, insulin, IGF-1 and IGFBP-3 levels compared with healthy subjects (P0.05). Serum IGF-1 and IGFBP-3 levels were significantly correlated with insulin, MAC and height Z score in patients (P0.05). In controls, significant positive correlations were found between BMI, IGF-1 and leptin (P0.05).Energy malnutrition is characterized by the important decreases in the leptin, insulin, IGF-1 and IGFBP-3 levels. Understanding details of these changes may lead to new therapeutic approaches in disease states associated with malnutrition.

Amac: Gelismis ulkelerde dusuk dogum agirlikli yenidoganlarin yaklasik %70’ini preterm yenidoganlar olusturmaktadir. Calismamizda 2010-2011 yillari arasinda hastanemiz yenidogan servisinde yatan dusuk dogum agirlikli bebeklerin geriye donuk olarak degerlendirilmesi amaclandi. Yontemler: Bu calismaya, 2500 gram alti dogan 626 yenidogan alindi. Retrospektif olarak, aile oykusu, natal, prenatal, postnatal, anne ve demografik ozellikleri ile risk faktorleri kaydedildi. Bulgular: Calismamizda anne yasi en sik 21-35 yas arasi, gebelik haftasi 33 hafta ustu, dogum agirligi 2001-2500 gram arasi ve mortalite orani %29,7 olarak bulundu. Dusuk dogum agirlikli bebeklerin dogum kilolarina gore karsilastirmalarinda; anne yasi, cogul gebelik orani, dogum yeri, dogum prezentasyonu, yatis suresi, erken dogum nedenleri ve mortalite oranlari arasinda istatistiksel olarak anlamli fark bulundu (p

Mastocytosis is a heterogeneous disease group which develops as a result of proliferation of mast cells in different tissues and/or organs or is observed with skin involvement. It is generally observed during childhood and progresses benignly. Mastocytosis may be detected in adults as well; however, the progress is severer and aggressive during adulthood. The most common organ involved is the skin and many organ involvements may also be observed such as bone marrow, liver, gastrointestinal system, spleen and lymph glands. Clinical findings in all disease types depend on the changes caused by release of active editors in granules of the mast cells. A solitary mastocytoma with a diameter of 1-3 cm which is a benign, elastic, infiltrated entity characterized with nodule or plaque with smooth or rough (orange peel) surface may be observed in cutaneous mastocytoma; however, life threatening clinical manifestations characterized with diffuse vesiculobullose lesions may also be detected. In the present study, 2 cases including one case with a benign clinical progress and one case resulted with death are presented. Therefore, it should be kept in mind that mastocytoma cases may progress with bad prognosis and families should be taught to avoid the patient from triggering factors, to apply practical treatment methods by the patient and to follow the patient closely.

Juvenile idiopathic arthritis (JIA) is a chronic inflammatory arthritis characterized by periods of remission and relapse. Mean platelet volume (MPV) is an indicator of systemic inflammation. In the present study, we aimed to determine the association between mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet distribution width (PDW) and clinical measures of diseases activity in children with JIA. The study included 115 patients with JIA (64 with active disease and 51 with inactive disease) and 64 age-gender matched healthy control subjects. Routine laboratory methods were used to measure white blood cell count (WBC), platelet count (PLT), neutrophil count, lymphocyte count, hemoglobin (Hb), MPV, PDW, NLR, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in all subjects of both the patient and control groups. Active disease was associated with significantly increased MPV (8.23 ± 1.16 fl) compared with inactive disease (7.00 ± 1. 08 fl) and control subjects (6.77 ± 1.08 fl) P

İlyas Yolbaş, Velat Şen, Bilal Sula, Lokman Timurağaoğlu, Hasan Balık Hyper-immunoglobulin E syndrome (Job syndrome) is a rare primary immunodeficiency with variable presentation, characterized by recurrent infections, facial dimorphism, eczema, scoliosis, joint hyper-extensibility, pathologic fractures, very high IgE (>2000 IU/mL), severe eosinophilia and variable impaired T cell function. We present a typical case of Hyper-immunoglobulin E syndrome in neonate with review of literature., Hiper-immunglobulin E sendromu (Job Sendromu), genellikle çok yüksek IgE (> 2000 IU/ml) seviyesi, şiddetli eozinofili, soğuk stafilokok cilt absesi ve pnömoni gibi tekrarlayan enfeksiyonlar, egzama, skolyoz, eklem hiperekstansibilitesi, patolojik kırıklar, tipik bir yüz görünümü, kraniyosinostoz ve değişken bozulmuş T hücre fonksiyonu ile karakterize nadir görülen primer immün yetmezlik durumudur. Hiper-immunglobulin E sendromu yenidoğan ve diğer yaş grubunda farklı laboratuar bulguları, klinik belirti ve bulguları gösterebilir. Bu çalışmada soğuk Stafilokokal cilt abseleri, hafif yüksek total serum IgE düzeyi (146 IU/ml, normal: 0-8 IU/ml), yüksek periferal eozinofili (% 15) ve normal serum IgA, IgG, IgG subclas, IgM, C3 ve C4 seviyelerine sahip hiper-immunglobulin E sendromu olan onbeş günlük erkek hasta sunuldu

Objectives: Nowadays, it has become more difficult treatment of the urinary tract infections because of developing high antibiotic resistance. The aim of this study was to investigate the most common causative microorganisms, their susceptibility and resistance to antibiotics in childhood urinary tract infections (UTI). Materials and methods: In this study, data belonging to urinary culture of 111 children with the diagnosis of UTI at Dicle University Medical School, Department of Pediatrics, throughout 1.5 years. Results: Of all cases 97 (87.4%) were female and 14(12.6%) were male. The most common complaints of children were dysuria, fever, flank pain and pollakiuria. Isolated microorganisms according to decreasing frequency were E.coli (75.7%), Klebsiella sp (7.2%), Proteus sp (6.3%) and Enterobacter sp (1.8%). The resistance rates against trimethoprim-sulfamethoxazole was 71.3%, ampicillin 82.4%, amoxicillin-clavulanate 54.7% and tetracycline 68.3%, and the least resistance rates were for ceftriaxone (16%) and amikacin (8.1%). Conclusion: In conclusion, the most common causative agent was E.coli and the highest resistance ratios were against trimethoprim-sulfamethoxazole, ampicillin and amoxicillin-clavulanate in children with UTI that presented in this study. Fewest ratio of resistance was found against amicasin and cephtriaxone.

Objectives: The aim of this study was to examine clinical and laboratory characteristics of children with AGN in a tertiary university hospital. Materials and methods: Hospital records of children, which hospitalized with AGN diagnosis in Pediatric Nephrology Unit, between 2004 and 2011, were retrospectively reviewed. Patients were divided into three subgroups as age 10 years. Characteristics at hospital admission including, blood pressure, diuresis state, serum urea, creatinine and electrolyte levels, complement factors C3 and C4, complete blood count and urine analysis results were recorded. Data about primary infection, treatments, disease course and outcome were recorded and analyzed. Results: Totally 220 children (157 male, 71.2%; 63 female, 28.8%) were included. Probable etiological infections were tonsillopharyngitis in 133 (60.5%), pyoderma in 12 (5.5%), other infections in 27 (12.2%) children. In 48 (21.8) children with AGN, no primary infection were detected. Edema was found in 81.4% of patients, hypertension in 73.6%, and pulmonary stasis in 22.6%. Low C3 levels were found in 89.1%, azotemia in 45.9%, hematuria in 95.4%, nephritic proteinuria in 80.5%, and leukocyturia in 37.6% of patients. Diuresis was enabled within one week in 82%. Additional vasodilators were given to 45 (20.5%) patients, and hemodialysis was performed to three. Except for frequency of low C3 (p=0.018) and anemia (p=0.006), no significant differences were found in clinical and laboratory findings between age groups (p>0.05). Conclusions: No difference was found in clinical and laboratory features of AGN based on age groups, excluding low C3 and anemia frequency., Amaç: Bu çalışmanın amacı üçüncü basamak bir üniversite hastanesinde akut glomerulonefrit (AGN)\'li çocukların klinik ve laboratuvar özelliklerini irdelemektir. Gereç ve yöntem: Çocuk Nefroloji Kliniğinde 2004-2011 yılları arasında AGN tanısıyla yatırılarak tedavi edilen çocukların kayıtları geriye dönük olarak incelendi. Hastalar 10 yaş üstü olmak üzere üç gruba ayrıldı. Hastaların hastaneye başvuru anındaki özellikleri olarak kan basıncı, diürez durumu, serum üre ve kreatinin değerleri, elektrolit düzeyleri ve kompleman C3 ve C4 faktörleri, tam kan sayımı ve idrar analiz bulguları kaydedildi. Ayrıca başlatan enfeksiyon, uygulanan tedaviler, klinik seyir ve sonuç belirlenerek kaydedildi ve elde edilen veriler analiz edildi. Bulgular: Hastaneye yatırılarak izlenen 63\'ü kız (%28,8), 157\'si erkek (%71,2), toplam 220 AGN\'li çocuk incelendi. Tetikleyen enfeksiyon olarak, tonsillofarenjit 133 (%60,5) hastada, piyoderma 12 hastada (%5,5), ve diğer enfeksiyonlar 27 hastada (%12,2) saptanırken; 48 hastada (%21,8) herhangi bir enfeksiyon bulunmadı. Hastaların %81,4\'ünde ödem, %73,6\'sında hipertansiyon, %22,6\'sinda akciğerde staz bulguları saptandı. Hastaların %89,1\'inde C3 düşüklüğü ve %45,9\'unda azotemi gözlendi. Hematüri %95,4 hastada, nefritik proteinüri %80,5\'unda, lökositüri %37,6\'sında görüldü. Diürez 180 (%82) hastada bir haftada normale geldi. Düretik tedavisi ile kan basıncı kontrol altına alınamayan 45 hastaya (%20,5) ilave vazodilatör ilaçlar verildi. Üç hastada hemodiyaliz yapıldı. Ancak AGN yaş grupları arasında, C3 düşüklüğü (p=0.018) ve anemi sıklığı (p=0.006) farklı bulunurken, diğer klinik ve laboratuvar bulgular bakımından anlamlı farklılık saptanmadı (p>0.05). Sonuç: Akut glomerülonefrit çocuklarda klinik ve laboratuvar özellikler yaş gruplarına göre C3 düşüklüğü ve anemi sıklığı dışında anlamlı farklılık göstermedi.

Aim: The aim of our study was to evaluate the epidemiologic, clinic and laboratory results and the answers to treatment of meningitis cases. Material and Method: In this study, the epidemiologic, clinic and laboratory results of 197 patients hospitalized with central nervous system infection diagnosis in the Department of Pediatric Health and Diseases of the Faculty of Medicine of Dicle University between 1st of January 2003 and 1st of January 2006 have been studied retrospectively. The files have been studied in details for age, sex, complaints, and results of physical examination, laboratory results, radiological results and treatments applied. Results: 118 of the patients were male, 79 were women and the mean age calculated was 62,2±47,3 months.137, 27 and 33 patients have been respectively considered as ABM, AM and TM. The most frequent complaints of application to hospital were fever (95,4%), vomiting (82,7%), headache (45,6%) and change of consciousness (21,3%). The presence of many risks about meningitis has been observed. The most frequent risk factors were head trauma history, parenchymal lung tuberculosis, military tuberculosis, presence of V-P shunt, meningocele, varicella history, having mumps, and the presence of purulent ear discharge. BOS has developed in 7 patients and for five patients, reproduction occurred in blood culture. The most important central nervous system sequels or complications were in order of frequency hydrocephalies requiring the installation of V-P shunt, brain edema, epilepsies, subdural effusions, tuberculoma, retention of head pair, and brain apses. The rate of mortality was (% 13,1). Discussion: During the period of execution of the study, the mortality and morbidity of central nervous system diseases were still at high risk. But this may be associated to the absence of vaccination programs for frequent meningitis factors such as pneumococcus and H. influenza were not in routine vaccination program in our country; thus we consider that further studies about this issue after vaccination are required.

The relationship between inflammation, oxidant stress and cardiovascular damage in children with chronic renal failure (CRF) has not previously been investigated. The aim of this study was to investigate markers of oxidative stress, inflammation and early cardiovascular abnormalities. Therefore, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities; blood glutathione (GSH) and serum malondialdehyde (MDA) levels; C-reactive protein (CRP) and proinflammatory cytokines (IL-6, TNF-alpha,); and left ventricular masses (LVM) and intima media thicknesses (IMT) were measured in children with CRF. A total of 29 children with CRF (19 nondialysis, 10 peritoneal dialysis) were included. The control group consisted of 25 healthy subjects. CRF children had significantly increased IL-6, TNF-alpha, CRP and MDA concentrations and decreased SOD, CAT and GSH levels compared with controls (P0.05). Nondialysis and peritoneal dialysis subgroups had similar oxidative stress and inflammation biomarkers (P0.05). Erythrocyte CAT was positively correlated with CRP, TNF-alpha, and IL2-R in the study group. Positive correlations were found between cytokine concentrations, CRP and urea/creatinine levels. Significantly increased LVM and IMT values were found in CRF children (P0.05). In conclusion, increased oxidant stress and inflammation together with early cardiovascular damage were found in CRF children. Further studies with more patients are needed to verify these results.

Toxic epidermal necrolysis (TEN) is a disease that mostly caused by drug use and characterized by acute onset and rapidly progressive necrosis of the epidermis. In severe cases, mortality rate change between 20% and 60%. Although there is no definite treatment, some authors have reported the effectiveness of intravenous immunoglobulin (IVIG). Here, we presented a 9-year-old male patient with TEN. Skin rashes of patient began after three days of using ibuprofen, metronidazole, clarithromycin, and procaine penicillin. Skin lesions resembling second-degree burns covered 50% of the patient\'s body surface area. After giving high-dose IVIG, the patient\'s lesions improved. This case is an example of effect of high dose IVIG in the treatment of TEN. J Clin Exp Invest 2013; 4 (4): 503-505, Toksik epidermal nekrolizis (TEN) sıklıkla ilaç kullanımı sonucu gelişen, akut başlangıçlı, çok hızlı ilerleyen, epidermis nekrozu ile karakterize bir hastalıktır. Şiddetli seyreden olgularda mortalite oranı %20-60 arasında değişir. Kesin tedavisi olmamasına rağmen intravenöz immünglobulin (İVİG) tedavisinin etkili olduğunu belirten yayınlar mevcuttur. Bu çalışmada; ibuprofen, metronidazol, klaritromisin ve prokain penisilin kullandıktan üç gün sonra deri döküntüleri başlayan ve %50 oranında ikinci derecede yanık düzeyinde lezyonlar ile TEN tablosu gelişen 9 yaşında erkek hasta sunulmuştur. Hastaya verilen yüksek doz İVİG tedavisi ile düzelme sağlandı. Bu olgu TEN tedavisinde etkinliği tartışmalı olan İVİG tedavisine olumlu yanıt alınabileceğine bir örnektir.

Cystic fibrosis (CF) is a genetic disease with autosomal recessive inheritance and is common in Caucasian people. The prevalence of this disease is between 1/2,000 and 1/3,500 live births, and the incidence varies between populations. Although the CF transmembrane conductance regulator gene is expressed in the kidneys, renal involvement is rare. With advances in the treatment of CF, life expectancy has increased, and some previously unobserved disease associations are now seen in patients with CF. It is important to follow patients with CF for possible abnormalities that may accompany CF. In this paper, we present two rare cases of CF accompanied by nephrotic syndrome.

Aim: Resistance to antibiotics is better. Between should not be in capitals. Antibiotics resistant has been increasing in pneumococci that cause serious diseases such as pneumonia, meningitis in recent years. The resistance rates vary between geographic regions. In this study, we aimed to determine antibiotic resistance rates in pneumococcal infections in our region. Material and Method: This study included 31 pneumococcal strains isolated from blood, CSF and urine samples of patients with meningitis, sepsis and urinary tract infections who admitted Dicle University Medicine School Children Clinic and Diyarbakir Pediatric Hospital Between December 2004-April 2007. Reproducing clinical specimens with alpha-hemolysis, optochin-sensitive, bile soluble and gram-positive diplococci morphology was defined as S. pneumoniae. The antimicrobial susceptibilities of strains were measured by the E-test method. MIC values of penicillin against pneumococci was accepted as

Congenital cystic adenomatous malformation (CCAM) of lung is a rare form of congenital hamartomatous lesions of the lung consisting of cysts filled with air. The general clinic presentation of CCAM is dyspnea in newborns. CCAM may mimic congenital pneumonia or respiratory distress syndrome. After the delivery, the newborn male who had low Apgar score and severe respiratory distress was intubated and admitted to neonatal intensive care unit. Patient was ventilated for 50 days and weaned from the mechanical ventilator at 50th day. Type II CCAM of the lung was diagnosed according to the chest radiographs and computed tomography scan signs. Although the surgeons suggested lobectomy considering the patient’s not completely asymptomatic, family did not accept this operation due to the risk of death. The patient was discharged from the hospital until the next control. Akciğerin konjenital kistik adenoid malformasyonu akciğerin hava ile dolu kistlerinden oluşan bir hemartöz lezyondur. Genelde doğumdan sonra solunum sıkıntısı ile bulgu verir. Konjenital pnömoni, respiratuvar distress sendromu ile ayırıcı tanısı zordur. Doğumdan sonra şiddetli solunum sıkıntısı ve düşük Apgar olan bir erkek yenidoğan entübe edildikten sonra yenidoğan yoğun bakım ünitemize yatırıldı. Hasta 50 gün mekanik ventilatörde takip edildikten sonra 50. gün mekanik ventilatörden ayrıldı. Tip II Akciğerin konjenital kistik adenoid malformasyonu tanısı akciğer tomografisi ve akciğer grafi bulguları ile kondu. Cerrahi lobektomi önermesine rağmen hastanın tümüyle aseptomatik olmaması ve ölüm riski nedeniyle aile operasyonu kabul etmedi. Hasta kontrole gelmek üzere taburcu edildi.

Diabetic ketoacidosis is a systemic situation caused by absolute insulin deficiency and characterized by hyperglyce-mia, ketonemia, acidemia, glycosuria and ketonuria. Thalassemia Major is a very serious hereditary blood disorder due to low levels or absence of "beta globulin" chain, characterized by requiring a blood transfusion from 3-4. month of life due to the relatively short life of red cells. We, herein presented a rare case of 20 day-old newborn with anemia, hyperglycemia, vomiting, acidosis being diag-nosed as thalassemia major that required blood transfusion in the early period of life and diabetic ketoacidosis with-out ketonuria who born from 24 year old father carrier of thalassemia and 23-year-old mother with carrier of thalas-semia and gestational diabetes. The case was presented in order to emphasize that diabetic ketoacidosis can occur in newborns without ketonuria and thalassemia major may cause anemia in the early period of life due to hyperglycemia and acidosis., Diyabetik ketoasidoz mutlak insülin yetersizliğine bağlı gelişen ve genellikle hiperglisemi, ketonemi, asidemi, glikozüri, ketoüri ile karakterize sistemik bir durumdur. Talasemi Major "beta globulin" zincirinin yapılamaması veya az yapıl-ması nedeniyle eritrosit ömrünün kısa olmasından kaynaklanan, hayatın 3.-4. ayında anemi bulguları görülmeye baş-layan ve zamanla sürekli kan nakli gerektiren çok ciddi kalıtsal bir kan hastalığıdır. Olgu sunumumuzda 24 yaşındaki talasemi taşıyıcısı bir baba ve 23 yaşındaki talasemi taşıyıcısı ve gestasyonel di-yabetli bir anneden doğan, anemi, hiperglisemi, kusma ve asidoz tablosuyla servisimize yatırılan ketonüri olmadığı halde diyabetik ketoasidoz ve erken dönemde eritrosit transfüzyonu gerektiren talasemi majorlu 20 günlük nadir görü-len bir olguyu sunduk. Yenidoğanlarda diyabetik ketoasidoz tablosunun ketonüri olmadan da görülebileceği ve talasemi major olgularında hiperglisemi ve asidozla birlikte erken dönemde aneminin de ortaya çıkabileceğine vurgu yapmak için olgu sunuldu.

Amac: Preeklamsi bebeklerde basta prematurite olmak uzere bebeklerde bircok saglik problemlerine neden olan bir sorundur. Bu calismada preeklamptik anne bebeklerinin klinik, laboratuvar ve demografik ozellikleri degerlendirildi. Materyal ve Metod: Bu calisma Ocak 2010-Aralik 2011 tarihleri arasinda Dicle Universitesi Tip Fakultesi Hastanesi Yenidogan Unitesi’nde izlenmis gebelik yasi 24-41 hafta arasinda degisen toplam 768 yeni doganin dosyalari retrospektif olarak incelendi. Preeklamptik anne bebegi 258 yeni dogan (105 erkek, 153 kiz) Grup I’i olustururken, saglikli anne bebegi olan solunum sikintisi ve premature gibi tanilarla yatan 468 yeni dogan (198 erkek, 270 kiz) kontrol grubunu yani Grup II’i olusturdu. Gruplar laboratuvar, klinik ve demografik ozellikler acisindan karsilastirildi. Bulgular: Ortalama anne yasi, gebelik sayisi, canli dogum sayisi, sezeryanla dogum sayisi, laktat dehidrogenaz degeri, potasyum degeri, prematurite orani, mortalite orani, yatis suresi, C-reaktif protein degeri, surfaktan uygulama orani, mekanik vantilator uygulanma orani, taze donmus plazma ihtiyaci, transfuzyonu ihtiyaci, hiperbilurubinemi, respiratuvar distres sendromu, mekonyum aspirasyonu sendromu orani grup 1‘de grup 2’ye gore istatistiksel olarak anlamli yuksek bulundu. Grup 1’de ortalama gebelik yasi, dogum agirligi, kalsiyum, total bilirubin ve eritrosit transfuzyonu ihtiyaci orani grup 2’ye gore istatistiksel olarak anlamli dusuk bulundu. Dusuk dogum sayisi, hemogram bulgulari, trombosit transfuzyonu ihtiyaci bakimindan iki grup arasinda istatistiksel olarak anlamli fark bulunmadi. Sonuc: Preeklamptik anne bebeklerinin dogum sonrasi yasadigi sorunlarin cogunun prematurite ve buna sekonder gelisen komplikasyonlar olusturmaktadir. Kaliteli yenidogan yogun bakim unitesi ve multidisipliner ekipler ile preeklamsiye bagli gelisen perinatal mortalite ve morbiditenin azaltilacagi kanisindayiz

Amac: Pseudomonas aeruginosa infeksiyonlari en sik gorulen hastane infeksiyonlaridir. Bu calismada, Dicle Universitesi Tip Fakultesi Hastanesi’nde izole edilen P.aeruginosa suslarinin direnc oranlarinin belirlenmesi amaclandi. Gerec ve Yontem: Calismamiza Haziran 2010 ve Haziran 2011 tarihleri arasinda Dicle Universitesi Tip Fakultesi Hastanesi’nde cesitli materyallerden izole edilen 171 hastaya ait P.aeruginosa kultur sonuclari alindi. P.aeruginosa suslarinin direnc oranlari klasik yontemlerle veya BD Phoenix (BD Diagnostic Systems, Sparks, MD) otomatik sistem kullanilarak belirlendi. Bulgular: Calismamiz 64 (%37.4) kiz ve 107 (%62.6) erkek olgudan olusuyordu. P. aeruginosa suslarinda direnc oranlari; siprofloksosin %50 (104/210), sefepime %43 (66/154), seftazidime %40 (63/158), gentamisin %32 (51/157), imipenem %25 (40/159), meropenem %25 (40/159), piperasillin/tazobaktam %23 (36/157), amikasin %14 (22/161), kolimisin %5 (2/37) olarak bulundu. Sonuc: Kultur materyallerinden izole ettigimiz P.aeruginosa suslarinda yuksek oranda antimikrobiyal direnc ve cogul direnc bulundu. Bu sonuclar direnc gelisimini engelleme amaciyla uygun, dar spektrumlu antibiyoterapi secimi ve hijyen kurallarina uyumun onemini gostermektedir

Objective: To determine relationship between blood lactate level and mortality rate in children admitted to the intensive care unit. Methods: 298 critically ill patients aged between 28 days and 16 years admitted to Dicle University Hospital, the third step Pediatric Intensive Care Unit in between January 2007 and December 2007 were included. Age, sex, diagnosis, Glasgow coma score points, the first measured blood lactate levels (lactate 1) and the arithmetic average of all measured blood lactate levels during treatment (lactate 2) of cases were evaluated. Patients were divided into group A (lactate < 20 mg/dl) and B (lactate ≥ 20 mg/dl). According to the results, patients were classified as survivors and non-survivors. Both lactate 1 and lactate 2 were compared with mortality rates. Results: In this study, a total of 298 patients were evaluated, 158 of them were nonsurvivors and 140 were survivors. A significant correlation was found between lactate levels and mortality rates. Lactate levels were higher in non-survivor cases (p, Amaç: Çocuk yoğun bakım servisinde takip edilen kritik hasta çocuklardaki kan laktat düzeyi ile mortalite arasındaki ilişkiyi belirlemek Yöntemler: Ocak 2007 ve Aralık 2007 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi, üçüncü basamak Çocuk Yoğun Bakım Ünitesinde takip edilmiş, kritik hasta 28 günden büyük ve 16 yaşından küçük çocuklar seçildi. Hastaların yaşı, cinsiyeti, tanısı, Glasgow koma skorlaması puanı, ilk ölçülmüş kan laktat düzeyi (laktat 1) ve tedavi sırasında tüm ölçülmüş kan laktat düzeylerinin aritmetik ortalaması (laktat 2) verileri retrospektif olarak değerlendirildi. Hastalar; grup A (laktat ≤19 mg/dl) ve grup B (laktat ≥20mg/dl) olarak iki gruba ayrıldı. Sonlanıma göre, hastalar yaşayanlar ve ölenler olarak iki gruba ayırıldı. Bu grupların mortalite oranları ve laktat düzeylerini karşılaştırıldı. Bulgular: Çalışmada; 140'ı yaşamış ve 158'i ölmüş olan toplam 298 vaka değerlendirildi. Laktat 1 ve laktat 2 seviyeleri ile mortalite arasında anlamlı bir ilişki bulundu. Ölen hastalarda laktat düzeyi anlamlı olarak daha yüksekti (p

Amaç: Acinetobacter baumannii suşları sahip oldukları antibiyotiklere karşı çoklu direnç geliştirme yeteneği sayesinde günümüzde neredeyse tedavi edilemez hastane kaynaklı enfeksiyonlarının patojeni haline gelmiştir. Çalışmamızda Dicle Üniversitesi Tıp Fakültesi\'nde çeşitli örneklerden izole edilen A. baumannii suşlarının direnç oranları belirlemesi amaçlandı. Yöntemler: Çalışmamıza Haziran 2010 ve Haziran 2011 tarihleri arasında Dicle Üniversitesi tıp fakültesi hastanesinde takip edilen hastalardan izole edilen 270 hastaya ait A. baumannii kültür sonuçları değerlendirildi. A. baumannii suşlarının direnç oranları klasik yöntemlerle ve BD Phoenix (BD Diagnostic Systems, Sparks, MD) otomatik sistemi kullanılarak belirlendi. Bulgular: Çalışmamız 82 (% 30.4) kadın ve 188 (% 69.6) erkek olgudan oluşuyordu. A. baumannii suşları için amikasin (% 76), ampisillin/sulbaktam (% 94), aztreonam (% 96), sefepim (% 95), sefotaksim (% 98), seftazidim (% 95), siprofloksasin (% 93), kolistin (% 6), gentamisin (% 94), imipenem (% 87), levofloksasin (% 87), meropenem (% 87), piperasillin/tazobaktam (% 92), tetrasiklin (% 84), trimetoprim/sulfametoksazole (% 82) direnç oranları görüldü. Sonuç: Kültürlerimizden izole ettiğimiz A. baumannii suşlarında kolistin hariç diğer antibiyotiklere karşı çok yüksek oranda direnç görüldü. Antibiyotik duyarlılığının bölgeler, hastaneler ve hatta kliniklerde yıldan yıla değişebileceği unutulmamalı ve direnç gelişimi sürekli izlenmelidir. Kültür sonucu çıkıncaya kadar ampirik tedavi seçilirken o yerin A. baumannii direnç oranları göz önünde bulundurulmalıdır. A. baumannii ile oluşan enfeksiyonlarda tedavi sırasında direnç gelişebileceği düşünülerek kültür ve antibiyogramlar tedavi sırasında tekrarlanmalıdır., Objective: Nowadays nearly, Acinetobacter baumannii has become an incurable nosocomial infections\' pathogen due to its ability developing multiple resistance against antibiotics strains In our study, it was aimed to determine rates of resistance of A. baumannii strains isolated from various samples in the Dicle University Hospital. Methods: A. baumannii culture results of 270 patients that were followed in the Dicle University Medical Faculty Hospital between June 2010 and June 2011 were evaluated. Resistance rates of A. baumannii strains were cultured by conventional methods and BD Phoenix (BD Diagnostic Systems, Sparks, MD) automated system. Results: Our study included 82 (30.4%) female and 188 (69.6%) male. Resistance rates of A. baumannii strains were as follows: amikacin (76%), ampicillin / sulbactam (94%), aztreonam (96%), cefepime (95%), cefotaxime (98%), ceftazidime (95%), ciprofloxacin (93%), colistin (6%), gentamicin (94%), imipenem (87%), levofloxacin (87%), meropenem (87%), piperacillin / tazobactam (92%), tetracycline (84%), trimethoprim / sulfamethoxazole (82%). Conclusions: A. baumannii strains isolated from our cultures have very high rate of resistance against antimicrobial agents except colistin. It should not be forgotten that antibiotic susceptibility may change from year to year in the regions, hospitals and even clinics, and resistance rates should be continuously monitored. When selecting empiric treatment, resistance rates of A. baumannii of that location should be considered until having culture results. In the infections caused by A. baumannii cultures and antibiograms should be repeated during treatment because that A. baumannii strains may change resistance ratio. J Clin Exp Invest 2013; 4 (3): 318-321