Asım Gültekin

Asymptomatic hypercalciuria : Prevalence and metabolic characteristics

Hypercalciuria is of continuing interest as a risk factor for kidney stones in children. We screened 592 healthy Turkish children (308 boys, 284 girls, aged 3 month-16 years) for hypercalciuria by measurement of urinary calcium/creatinine (UCa/Cr) ratio in the second-morning urine samples. Hypercalciuria was noted in 17 children (2.9 %), 9 of them were boy and 8 of them were girl. Oral calcium-loading test could only be done in 7 children who were diagnosed as having hypercalciuria, and it revealed absorptive hypercalciuria in 2 cases and renal hypercalciuria in no cases. The frequency of a family history of urolithiasis in asymptomatic hypercalciuric children was 50%. Median UCa/Cr ratios and urinary magnesium/creatinine (UMg/Cr) ratios were 0.11 and 0.10 and the 97th percentiles were 0.32 and 0.23 respectively. The UCa/Cr ratio in second-morning urine samples was correlated with the UMg/Cr ratio (r = 0.44) and was independent of age and sex.

Acute renal failure related to infectious disease in infancy and childhood

In this prospective study done between 1983 and 1989, of 109 children with acute renal failure in Sivas, Turkey, infectious disease was found in 94. This was related mainly to preventable disease such as acute gastro-enteritis, sepsis and post-streptococcal acute glomerulonephritis. Within this infectious disease group, the highest incidence rate was found in sepsis.

The prevalence and outcomes of thrombocytopenia in a neonatal intensive care unit: a three-year report.

Neonatal thrombocytopenia is one of the most common hematologic disorders in neonatal intensive care units (NICUs). The purpose of this study was to determine the prevalence of thrombocytopenia and whether thrombocytopenia has an effect on the occurrence of intraventricular hemorrhage (IVH) ≥ grade 2 and on mortality rate. This study was carried out retrospectively in neonates admitted to NICU of Cumhuriyet University in Sivas, Turkey, between 2009 and 2012. Among 2218 neonates evaluated, 208 (9.4%) developed thrombocytopenia. The prevalence of IVH ≥ grade 2 was more in infants with thrombocytopenia (7.2%) than in those without thrombocytopenia (4.4%), although this was not statistically significant (P = .08). In univariate analysis, IVH ≥ grade 2 was higher in cases with very severe thrombocytopenia (35.7%, n = 5) than in those with mild (2.1%, n = 2), moderate (4.7%, n = 3), and severe thrombocytopenia (15.2%, n = 5) (P = .04). Multivariate logistic regression analysis showed that birth weight <1500 g (OR 6.2, 95% CI 3.4–9.8; P = .0001), gram-negative sepsis (OR 2.5, 95% CI 1.8–4.2; P = .01), very severe thrombocytopenia (OR 1.3, 95% CI 1.1–2.1; P = .03), and platelet transfusion ≥2 (OR 7.3, 95% CI 4.1–12.1; P = .001) were significant risk factors for mortality. The results of our study suggest that outcomes of neonates with thrombocytopenia depend not only on platelet count but also on decreased gestational age or birth weight, prenatal factors, and sepsis.

Gestational age assessment in preterm neonates weighing less than 2500 grams.

Postnatal assessment of gestational age (GA) in preterm neonates is traditionally performed using the methods of Dubowitz and Ballard. Dubowitz et al. in 1970 Ballard et al. in 1977 and in 1991 Tuncer et al. in 1982 introduced a scoring system for GA determination in an attempt to improve the accuracy of assessment. Our study has been designed to determine the accuracy of Dubowitz Ballard and Tuncer methods in a sample of low birth weight preterm neonates. Neonates included in this study are 91 preterm singletons with GA ranging from 28 to 38 weeks delivered during a 2-year period. All neonates met the following criteria: 1) birth weights less than 2500 g; 2) reliable GA by last menstrual period (LMP); and 3) complete Dubowitz Ballard and Tuncer neonatal examination performed. All Dubowitz Ballard and Tuncer examinations were done in the first 30-42 h of life by one of three pediatricians masked to the presumed GA. (excerpt)

Akut dissemine ensefalomyelit olgularının değerlendirilmesi

Amac. Cocukluk caginin postenfeksiyoz, demiyelinizan santral sinir sistemi hastaliklarindan akut dissemine ensefalomyelitin (ADEM) tani, klinik seyir, tedavi ve sonuclarinin arastirilmasi amaclandi. Yontem. Pediatrik Noroloji Bilim Dalinda Ocak 2008-Ocak 2009 araligindaki bir yillik zaman diliminde ADEM tanisi ile takip edilen alti hastanin oykuleri, klinik ozellikleri, laboratuar ve radyolojik bulgulari gozden gecirildi. Bulgular. Olgularimizin ikisi kiz, dordu erkek idi. Bir hastada gecirilmis sucicegi enfeksiyonu, bes hastada gecirilmis ust solunum yolu enfeksiyonu oykusu vardi. En sik gorulen basvuru semptomlari dengesizlik, yurume bozuklugu ve kusma idi. Bir hasta hemiparezi, afazi ve fasiyal paralizi ile basvurdu. Bir hastada takibi sirasinda multifazik dissemine ensefalomyelit (MDEM) dusunuldu. Olgularin besinin kranial magnetik rezonans goruntuleri (MRG) ADEM ile uyumlu bulunurken bir olgunun ilk kranial MR goruntusu pons gliomu olarak yorumlanmisti. Tum olgulara manyetik rezonans spektroskopi (MRS) yapildi. Sonuc. ADEM’de erken tani ve uygun tedavi ile ciddi norolojik sekellerin onlenebilecegi ve diger demiyelizan hastaliklarla ayirici tani yapilmasinin onemli oldugu akilda tutulmalidir

Sivas il merkezinde kreş ve anaokullarında sekretuvar otitis media prevalansı

Bu calismada sekretuvar otitis media prevalansini ve ilgili risk faktorlerini belirlemeyi amacladik Sivas ta kres ve anaokullarinda 2 6 yas arasi 606 cocukta sekretuvar otitis media prevalansi arastirildi Sekretuvar otitis media tanisi otoskopik muayene ve timpanometri ile konuldu Ortalama prevalansi 18 8 olarak bulundu Daha once ve son bir yilda orta kulak iltihabi oykusu sik ust solunum yolu enfeksiyonu oykusu ailede kulak iltihabi ve allerjik hastalik oykusu kalabalik aile odasini birden fazla kisi ile paylasma dusuk dogum agirlikli dogma yetersiz anne sutu alma lt;5 ay ile sekretuvar otitis media arasi anlamli bir iliski bulundu Sekretuvar otitis media sikligi 2 yasta en yuksek iken 5 yasta ikinci bir pik goruldu Cinsiyet ve sigara ile sekretuvar otitis media arasi anlamli bir iliski saptanmamakla birlikte sigaraya maruz kalan cocuklarda sekretuvar otitis media sikligi daha yuksekti Sekretuvar otitis mediaya bagli isitme kayipli cocuklarin 63 unun ailelerince 89 unun ogretmenlerince fark edilmedigi saptandi Sekretuvar otitis media tespit edilen cocuklarin okul basarilarinin dusuk oyun ders ve aktivitelere ilgilerinin az oldugu bulundu Anahtar kelimeler: Sekretuvar otitis media prevalans risk faktorleri

Yenidoğan Döneminde Hematolojik Bulgularla Ortaya Çıkan Bir Fanconi Anemisi Olgusu

Familial hemophagocytic lymphohistiocytosis was diagnosed in a three and a half month old infant with anemia hepatosplenomegaly and intractable fever Three siblings had died due to unknown causes The diagnosis was verified with autopsy Clinical and laboratory findings of the case are discussed in the light of literature Key words: Familial Hemophagocytic Lymphohistiocytosis