Candemir Karacan

Evaluation of Urine Collection Methods for the Diagnosis of Urinary Tract Infection in Children

Objective: To evaluate the accuracy of urine sample collection methods among children suspected of having urinary tract infections. Subjects and Methods: Four methods for urine sample collection were evaluated in 1,067 children aged 0–16 years with suspected urinary tract infections over 2 months at Dr. Sami Ulus Children’s Hospital. Within 30 min of collection, all specimens were sent to the laboratory, refrigerated and processed according to standard hospital microbiological procedures. Urine samples were analyzed using routine culture techniques. Results: At initial sending of the urine culture, 617 (57.8%) had negative culture results, 145 (13.6%) had positive culture results, and 305 (28.6%) had evidence of bacterial contamination. Clean catch specimens showed a contamination rate of 14.3% and urethral catheterization specimens showed a similar contamination rate (14.3%). However, urethral catheterization was preferred in only a small number of cases (n = 7). Suprapubic aspiration was also used in a small number of cases (n: 11) and the contamination rate for suprapubic aspiration was 9.1% (n: 1/11). The contamination rate for sterile urine bag was 43.9%, significantly higher than the other methods (p < 0.001). Conclusion: Suprapubic aspiration showed the lowest contamination rate and sterile urine bag showed the highest contamination rate among 4 methods of urine sample collection. Contaminated specimens, needed to be repeated and this procedure increased the cost of urine culture. In conclusion, measures should be taken to reduce the contamination rate in our center. This is an area where further investigation is required.

Effect of passive smoking on growth and infection rates of breast‐fed and non‐breast‐fed infants

Background:  The aim of the present study was to determine the effect of passive tobacco smoking on growth and infection rate of infants, and to evaluate whether breast‐feeding might be protective against harmful effects of cigarette smoke.

Parents' perspectives to childhood fever: Comparison of culturally diverse populations

Aim:  To reveal the perceptions, knowledge and practices of our parents regarding childrens fever and to discuss the differences between other populations.

An intervention to preschool children for reducing screen time: A randomized controlled trial

BACKGROUND Screen time, defined as time spent watching television, DVDs, or videos or playing computer or video games, has been related to serious health consequences in children, such as impaired language acquisition, violent behaviour, tobacco smoking and obesity. Our aim was to determine if a simple intervention aimed at preschool-aged children, applied at the health maintenance visits, in the primary care setting, would be effective in reducing screen time. METHODS We used a two group randomized controlled trial design. Two- to 6-year-old children and their parents were randomly assigned to receive an intervention to reduce their screen time, BMI and parental report of aggressive behaviour. At the end of the intervention we made home visits at 2, 6 and 9 months and the parents completed questionnaire. RESULTS Parents in the intervention group reported less screen time and less aggressive behaviour than those in the control group but there were no differences in BMI z scores. CONCLUSIONS This study shows that a preschool-based intervention can lead to reductions in young childrens television/video viewing.

Evaluation of shigellosis in a Turkish children’s hospital

Background: The aim of the present study was to evaluate cases of Shigella and determine the pattern of antimicrobial resistance of shigella species in central Turkey.

A Single-Center Experience of Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infection

Objective: To assess the prevalence of urinary tract pathogens and their resistance patterns against antimicrobial agents in a single center. Patients and Methods: In children <16 years of age admitted for urinary tract infection (UTI) to the Dr. Sami Ulus Teaching and Training Hospital from January 2004 to December 2008, positive urine cultures were reviewed. Results: A total of 3,485 positive urine cultures were identified, of which 2,379 (68%) were from females and 106 (32%) from males. Their mean age was 63.5 ± 40.7 months. Escherichia coli was the most common causative agent both in total and among different age groups. Ampicillin had the highest resistance rate from all the pathogens isolated (63.8%), followed by piperacillin (51.8%) and trimethoprim-sulfamethoxazole (TMP-SMX; 48.6%). Cephalotin also had a high resistance rate (32.7%). The least resistance was for imipenem, amikacin, netilmicin and ciprofloxacin (0.13, 1.7, 2.4 and 7.5%, respectively). None of the Klebsiella and Pseudomonas isolates were resistant to imipenem. None of the Staphylococcus aureus isolates were resistant to teicoplanin and vancomycin. Vancomycin-resistant Enterococcus spp. were isolated from two cultures. Conclusion:E. coli was the most common causative agent of UTI in children. Ampicillin, TMP-SMX or cephalothin and piperacillin had the highest resistance rates against urinary tract pathogens in our center.

The effect of passive smoking and breast feeding on serum antioxidant vitamin (A, C, E) levels in infants

Aim: Toxic substances in tobacco smoke are known to have negative effects on the antioxidant capacity of human body. In order to investigate the effect of passive smoking on serum antioxidant levels in infants, serum vitamin A, E, C levels and urinary cotinine/creatinine levels were measured in 254 infants at the age of 6 months.

Visual hallucinations possibly associated with clarithromycin administration at therapeutic dosage in two children.

Objective: Our aim was to present 2 children with visual hallucinations possibly associated with clarithromycin administration at therapeutic dosage. Subjects and Methods: Two children were admitted to our hospital with sudden onset of visual hallucinations after taking clarithromycin at therapeutic dosage by mouth. Physical examination, laboratory investigations and imaging studies were normal. The symptoms gradually disappeared once the clarithromycin therapy had been discontinued, making us suspect clarithromycin as the agent responsible for the visual hallucinations. They were observed monthly for a year without any symptoms or further treatment. Conclusion: This report highlights hallucinations due to therapeutic doses of clarithromycin therapy as a possible new side effect in children.

Familial primary carpal tunnel syndrome with possible skipped generation

Carpal tunnel syndrome, an entrapment neuropathy of the median nerve, is rarely seen in childhood. Familial carpal tunnel syndrome, an even more exceptional entity, is frequently associated with inherited systemic disorders. Rarely it can be presented as a primary familial form with Mendelian autosomal dominant inheritance. We report the occurrence of carpal tunnel syndrome in two generations of a family in which the index case was a 6-year-old boy with bilateral hand pain and paresthesias. Our report demonstrates an interesting inheritance pattern of carpal tunnel syndrome in a family transmitted by an autosomal dominant gene with variable expressivity and reduced penetrance. To our knowledge, it is the first report of familial bilateral carpal tunnel syndrome in a family with possible skipped generation.

Rubinstein Taybi Syndrome with Hepatic Hemangioma

Objective: It was the aim of our study to present a case of Rubinstein Taybi syndome (RTS) associated with hepatic hemangioma. Clinical Presentation and Intervention: A 6.5-year-old boy was diagnosed with RTS. He had large areas of cutaneous capillary hemangiomas. Radiological examination revealed a hepatic hemangioma. A multidisciplinary follow-up program was commenced and hepatic ultrasound examinations were performed periodically. No progression and complication have since occurred. Conclusion: This case shows an association between RTS and hepatic hemangioma, and hence, we recommend regular hepatic ultrasound examination when RTS is suspected or diagnosed.