Habip Almis

The Association between Vitamin D Levels and Urinary Tract Infection in Children

Aim: We aimed to examine whether there is any association between serum levels of 25-hydroxyvitamin D [25(OH)D3] and urinary tract infection (UTI) among children. Methods: White blood cell count, serum C-reactive protein, calcium, phosphorus, alkaline phosphatase, parathormone, and serum 25(OH)D3 levels were measured in 82 children experiencing a first episode of UTI, with no risk factors for UTI, and 64 healthy control children. Results: The mean serum levels of 25(OH)D3 among children with UTI were significantly lower than those of controls (11.7 ± 3.3 vs. 27.6 ± 4.7 ng/ml; p < 0.001). The serum levels of 25(OH)D3 were significantly lower in patients with acute pyelonephritis compared to patients with lower UTI (8.6 ± 2.8 vs. 14.2 ± 3.0 ng/ml; p < 0.001). Within the study group, mean serum levels of 25(OH)D3 among girls were lower than those of boys (10.9 ± 3.4 ng/ml vs. 13.2 ± 4.4 ng/ml; p < 0.001). Multivariate analysis showed that a serum 25(OH)D3 level of <20 ng/ml (odds ratio 3.503, 95% confidence interval 1.621-7.571; p = 0.001) was associated with UTI in children. Conclusions: Our results suggest that vitamin D deficiency may be a risk factor for UTI in children.

Is there a relationship between low vitamin D and rotaviral diarrhea

For children under 5 years of age, 1700 000 000 episodes of diarrhea are seen worldwide, and death occurs in 700 000 of these cases due to diarrhea. Rotavirus is an important cause of diarrhea in this age group, and many studies have shown that vitamin D plays a pivotal role in the immune system, as well as in antimicrobial peptide gene expression. In addition, lower vitamin D has been correlated with higher rates of infectious diseases such as respiratory tract infection, tuberculosis, and viral infection.

Choroidal Thickness in Children with Beta Thalassemia Major.

Purpose The purpose of this study was to determine whether there are differences in choroidal thickness in children with beta thalassemia major (&bgr;-TM). Methods Thirty-five patients with &bgr;-TM and 38 healthy children aged between 3 and 16 years participated in the study. After complete eye examinations were conducted on the participants, choroidal thickness measurements were performed using optical coherence tomography. Correlations between choroidal thickness and laboratory and clinical parameters, such as age, sex, hemoglobin and ferritin levels, duration of disease, type and duration of chelating therapy, visual acuity, intraocular pressure, central corneal thickness, and axial length were also evaluated. Results The mean ages for the study group and for the control group were 8.2 ± 2.7 and 7.9 ± 2.4 years, respectively. There were no statistical differences between groups in terms of visual acuity, intraocular pressure, central corneal thickness, or axial length (p > 0.05). Choroidal thicknesses at the foveal center were 286 ± 33 &mgr;m in &bgr;-TM patients and 335 ± 423 &mgr;m in the healthy control children. Choroidal thicknesses at each point within the horizontal nasal and temporal quadrants were thinner in the &bgr;-TM group. There was a positive correlation between choroidal thickness and hemoglobin levels and a negative correlation between choroidal thickness and ferritin levels (r = 0.924, p < 0.001 and r = -0.947, p < 0.001, respectively). There was no correlation between clinical or ocular characteristics and choroidal thickness. Conclusions Choroidal thickness was significantly thinner in all quadrants in children with &bgr;-TM. This thinning of the choroid may be the reason for the development of eye disorders in older patients with &bgr;-TM.

Acute irritant bullous contact dermatitis caused by Euphorbia helioscopia

E. helioscopia (sun spurge) is used in traditional medicine in Turkey to treat warts, rheumatic pains, and superficial tissue swelling (2). 12-Deoxyphorbol13-phenylacetal-20-acetate is considered to be the most irritant component in the sap (3, 4). The bullous lesions that developed on our patients’ skin occurred after only brief exposure to the sap of the plants. Only a few cases of contact dermatitis associated with E. helioscopia have been reported previously in the literature (1, 5). The plants constitute a risk to children, who may be exposed to the sap during play, and to those who may be exposed when the plants are used in traditional medicine.

An Overview of Antibacterial Resistance Patterns of Pediatric Community-Acquired Urinary Infections.

Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community‐acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics.

The First Infant Death Associated With Human Coronavirus NL63 Infection.

Human coronavirus NL63 (HCoV-NL63) primarily infects the upper respiratory tract. However, it may cause severe lower respiratory tract infection, and the clinical course may be severe in immunocompromised patients. To our knowledge, child death due to HCoV-NL63 has not been reported. We present a fatal lower respiratory tract disease associated with HCoV-NL63 in a 7-month-old malnourished infant.

Evaluation of Childhood Vaccine Refusal and Hesitancy Intentions in Turkey

ObjectiveTo assess the factors affecting parental childhood vaccine refusal and hesitancy (CVRH) intentions in Turkey.MethodsA total of 33 children’s parents who were referred to two different child health care clinics because of CVRH and 99 controls were enrolled into this study from November through December 2017. The socio-demographic characteristics and perceptions of the parents who refused at least one vaccine for their child/children were compared with controls.ResultsThe monthly household income was significantly lower in CVRH group than control group. Refusal of the heel stick, refusal of hearing test, not using baby car seat, irregular use of vitamin D and iron prophylaxis, using alterative/complementary medicine, distrust in vaccines were the parameters which were found significantly higher in refused vaccine group than in control group. The beliefs “It may be dangerous for children” and “Distrust to the vaccines” were the most determined factors with a ratio of 51.5% in CVRH group.ConclusionsThis is the first study conducted to investigate the social-demographic characteristics and perception of parental CVRH in Turkey. The beliefs “It may be dangerous for the children” and “Distrust the vaccines” were the most determined factors which may affect CVRH. Some child health protective strategies were less undertaken in CVRH group than in controls; including heel stick test, hearing test, using baby car seat and using of Vitamin D and iron prophylaxis. The parents who have CVRH intentions tend to behave irresponsibly in care of their children.

Varicella pseudo‐koebner phenomenon associated with vascular access opening

ultraviolet radiation were suggested as possible explanations. Of those recorded cases, seven were localized to the head and neck (H&N) region, four of which involved the ear or surrounding structures. HPV-associated cyst (HPAC) with subsequent malignant change has been reported on only one previous occasion, which involved the perineum. HPV-associated malignancy of the H&N is well recognized, but the literature contains no reports of HPV-associated malignant change of an epidermoid cyst affecting this area. Previous attempts to isolate HPAC in cases of SCC within epidermoid cysts of the H&N have been unsuccessful. Histological features such as papillomatosis and hypergranulosis were identified in our case involving the conchal bowl. HPV is known to infect keratinocytes and follicular epithelium, and to cause a cutaneous cyst known as a verrucous cyst. HPV is known to possess malignant transforming properties in the setting of epidermodysplasia verruciformis. Possible malignant change of an epidermoid cyst should be considered in all cystic lesions with atypical clinical appearance, behaviour or histopathology. Clinical suspicion is essential to allow early diagnosis, imaging and comprehensive surgical excision.

A retrospective evaluation of 44 patients followed-up with a diagnosis of deep neck infection

Aim: he purpose of this study was to evaluate the demographic data and clinical features of patients diagnosed with deep neck infection over a one-year period and hospitalized for treatment in a tertiary training and research hospital. Material and methods: Files for cases treated and followed-up for deep neck infection in ourpediatric department during 2017 were evaluated retrospectively. Age, sex, month of presentation, presentation symptoms, physical examination findings, laboratory results, radiological imaging, consultations requested from other departments, treatments administered, number of days of hospitalization, and complications developing were assessed from these case files. Results: Twenty-eight (63.6%)of the 44 patients hospitalized for treatment for deep neck infection in the pediatricdepartment were boys, and 16 (36.4%) were girls. Patients’ mean age was 57.45 ± 44.35 (5-191) months. Mean duration of hospitalization and treatment was 8.2 ± 2.8 (4-14) days. The most common presentation symptom was swelling in the neck (65.9%), and the most common physical examination finding was cervical lymphadenopathy (81.8%). Tooth decay was present in 27.3% of patients. Consultations were most commonly requested with the ear, nose and throat department, while consultations were requested with the external diseases department for five patients (11.3%). Conclusion: The prevalence of deep neck infection has increased in recent years.Further studies are needed on the subject of deep neck infection, which may involve life-threatening complications. Physicians should pay closeattention to the relation between tooth decay and deep neck infection in all patients followed-up with a diagnosis of such infection.

Joint diagnosis of pediatric and dermatology clinics: Prospective observation of thirtynine patients with hand, foot and mouth disease

Address for Correspondence/Yazışma Adresi: İbrahim Hakan Bucak MD, Adıyaman University Faculty of Medicine, Department of Pediatrics, Adıyaman, Turkey Phone.: +90 416 216 10 15 E-mail: ihbucak@hotmail.com Received/Geliş Tarihi: 21.03.2016 Accepted/Kabul Tarihi: 18.07.2016 Adıyaman University Faculty of Medicine, Department of Pediatrics, *Department of Dermatology, Adıyaman, Turkey İbrahim Hakan Bucak, Birgül Tepe*, Habip Almiş, Ahmet Köse, Mehmet Turgut