Feyzullah Cetinkaya

Intravenous Immunoglobulin Treatment in Children with Guillain-Barre Syndrome

Guillain-Barre syndrome is an acquired demyelinating polyneuropathy that is presumed to be immune-mediated. On the basis of this assumption, intravenous immunoglobulin (IVIG) has been used in the treatment of Guillain-Barre syndrome in recent years and found to be effective. To test this we performed a randomized study in patients with Guillain-Barre syndrome by giving IVIG (1 g/kg body weight per day over 2 consecutive days) in 9 children who were compared with 9 patients who were observed but not given specific therapy. We concluded that intravenous immunoglobulin is a safe and effective treatment for childhood Guillain-Barre syndrome which shortens the time to recovery.

NUTRITIONAL VITAMIN B12 DEFICIENCY IN HOSPITALIZED YOUNG CHILDREN

The authors sought to determine prevalence, social, economic, and dietary patterns of young children (n = 20) identified as having vitamin B12 deficiency anemia after admission to their hospital in the last 3 years. The diagnosis of vitamin B12 deficiency was based on symptoms and clinical findings, findings on peripheral blood films and bone marrow aspirates, and serum levels of vitamin B12. The children had been exclusively breast-fed without any animal food supplementation. Serum vitamin B12 levels were also measured in the sera of mothers and found to be low. The authors concluded that vitamin B12 deficiency might be an important health problem among children of mothers who do not consume animal foods adequately.

Comparison of two antibiotic regimens in the empirical treatment of severe childhood pneumonia

Objective: The diagnosis and the treatment of community-acquired severe pneumonia is still a serious child health problem in developing countries. The aim of this study is to evaluate the effectiveness of two different antibiotic regimens in the empirical treatment of severe childhood pneumonia.Methodology: We enrolled 97 infants (aged 2–24 months) with severe community-acquired pneumonia in a randomized-controlled trial of 10 days of treatment with penicillin G+chloramphenicol (n:46) or ceftriaxone (n:51). We evaluated the effectiveness of treatments with symptoms and some laboratory tests during and at the end of the study.Results: The cure rates were similar in both groups and the antibiotic regimens in all patients were found effective (P< 0.001). The number of nurse rounds was much more in penicillin plus chloramphenicol group than ceftriaxone group.Conclusion: Both penicillin G plus chloramphenicol and ceftriaxone are effective in the empirical treatment of severe community pneumonia of young children. In spite of more nurse visits for antibiotic treatment, penicillin G+ chloramphenicol combination may be a cheaper alternative to ceftriaxone in the treatment of childhood pneumonia.

Effects of nebulized corticosteroids therapy on hypothalamic-pituitary-adrenal axis in young children with recurrent or persistent wheeze

Inhaled corticosteroids (ICS) are preferred drugs for the long‐term treatment of all severities of asthma in children. However, data about the safety of ICS in infants is lacking. So, it is essential to do further clinical studies to examine the safety and efficacy of ICS in this population. In this study, the effects of nebulized budesonide and nebulized fluticasone propionate suspensions on hypothalamic–pituitary–adrenal axis is examined in infants with recurrent or persistent wheeze. Thirty‐one children aged 6–24u2003months admitted to our hospital between January and December 2005 with symptoms of recurrent or persistent wheeze were included in the study. The patients were randomly allocated to receive 0.25u2003mg BUD or 0.25u2003mg fluticasone propionate twice daily for 6u2003wk and half dose for another 6u2003wk with a jet nebulizer at home. Blood samples for basal cortisol concentration, adrenocarticotropic hormone, glucose, HbA1c and electrolytes were obtained at the beginning and at the end of the study. Adrenal function assessment was based on changes in cosyntropin‐stimulated plasma cortisol levels. The study was completed with 31 patients, 16 of whom received BUD and 15 FP. All patients except one had plasma cortisol concentrations above 500u2003nmol/l (18u2003μg/dl) or had an incremental rise in cortisol of >200u2003nmol/l after stimulation. Although nebulized steroids seem to be safe in infancy, we recommend that adrenal functions should be tested periodically during long‐term treatment with nebulized steroids.

Severe iron-deficiency anemia among hospitalized young children in an urban hospital.

The aim of this study was to investigate the prevalence and some characteristics of young children with severe iron deficiency anemia hospitalized in an urban hospital. All of the young children (aged 7-24 months) hospitalized in a city hospital during the last three years were searched for iron deficiency anemia and those with severe anemia were retrospectively evaluated. During this period, 3117 young children were hospitalized and 61.6 % of them had a hemoglobin value of less than 11 g/dL and fifty two children (2.7%) had severe iron deficiency anemia (Hemoglobin<6 g/dL). It was concluded that iron deficiency anemia is still an important health problem among young children in our society.

Two-Dimensional Ultrasonographic Findings of Atelectatic Lung Segments

Thirteen cases with pulmonary atelectasis were examined by two-dimensional sonography in our clinics between October 1990 and April 1993. Patients’ ages ranged from 2 to 16 years. Five patients revealed atelectasis with pleural effusion and eight patients had only atelectasis. Two-dimensional sonography showed a solid mass indistinguishable from lung parenchyma in patients with atelectatic lung segment without pleural effusion while atelectatic segment was readily identified in those with pleural effusion. We conclude that sonography is a useful and non-invasive technique in differentiating cardiac from extracardiac masses, because atelectatic lung segment with moderate to large pleural effusion may mimic intrapericardial masses.