Halit Özkaya

Ghrelin Levels and Postnatal Growth in Healthy Infants 0-3 Months of Age

Objective: The effect of ghrelin on growth of the newborn has long been argued, but not fully clarified. In this study, we aimed to investigate the relationship between ghrelin levels and growth parameters in the first 3 months of life. Methods: The study included 60 babies (27 girls and 33 boys) born at gestational ages between 38-42 weeks. The newborns were divided into three groups according to the Lubchenco curves as: small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). The relationship between ghrelin levels and growth parameters in the third month was investigated. Results: Ghrelin concentrations were significantly higher in SGA (2.4±2.6 ng/dL) babies than in AGA (1.3±0.9 ng/dL) and LGA (1.0±0.8 ng/dL) babies. The lowest ghrelin levels were in the LGA group. In SGA infants, ghrelin concentrations were inversely correlated with change in weight (r=-0.577; p=0.001), change in length (r=-0.361; p=0.005), and change in head circumference (r=-0.387; p=0.002). Conclusion: The results show that at age 3 months, SGA infants had higher ghrelin levels than AGA and LGA infants. Our findings indicate that ghrelin may be involved in the process of catch-up growth in these infants. Conflict of interest:None declared.

A Case of Cerebello-oculo-renal Syndrome with Situs Inversus Totalis: A New Phenotype

Cerebello-oculo-renal syndromes are rare, autosomal recessive syndromes with uncertain nosology. Cerebello-oculo-renal syndromes involve many congenital malformations and may be associated with other disorders. The authors present a case of cerebello-oculo-renal syndrome with situs inversus totalis from a consanguineous family. The patient had cerebellar vermis hypoplasia, ocular abnormalities (Leber congenital amaurosis with retinal dystrophy, abnormal eye movements), developmental delay, growth deficiency, severe renal failure, and severe anemia. Imaging studies showed molar tooth sign, which was compatible with cerebello-oculo-renal syndromes and situs inversus totalis.

Carbamazepine-induced Red Blood Cell Aplasia: A Case Report.

A 2-year-old boy developed pure red cell aplasia (PRCA) during carbamazepine (CBZ) therapy. There was no history of prolonged or profuse bleeding after cuts or injury, and no bleeding from any sites of the body, petechiae, ecchymosis, or bruising. His family history of hematological disorders was negative. The child had been receiving CBZ therapy at a daily dose of 10 mg kg–1 for the last 6 months due to generalized tonic clonic seizures. One month before starting CBZ the boy’s complete blood count was analyzed due to anorexia and the findings were normal.

Pediatric malpractice: An overview of Turkey

The objective of this study was to evaluate juridical and medical responsibilities of health‐care professionals accused of malpractice in Turkey while they care for patients under the age of 18.

A CASE OF CEFTRIAXONE-INDUCED TOXIC EPIDERMAL NECROLYSIS IN GENITAL AREA

ABSTRACT We present a 2-year-old Turkish boy who was treated with ceftriaxone several days for acute tonsillitis, complicated with toxic epidermal necrolysis (TEN) that was initially diagnosed as drug eruption. The advantages of a long half-life, wide spectrum, high tissue penetration rate, and a good safety profile, make ceftriaxone, a thirdgeneration cephalosporin, a frequent choice in the treatment of childhood infections. To the best of our knowledge, this is the first case of ceftriaxone-induced toxic epidermal necrolysis in genital area in the English literature. Key words: Drug hypersensitivity, adverse drug reaction, toxic epidermal necrolysis, ceftriaxone

Juvenile alexander disease: a case report.

Alexander disease is a rare autosomal recessive disorder that is characterized by degeneration of the white matter in the central nervous system. Alexander disease is a leukodystrophy that is usually observed in early childhood but rarely in adults. It is characterized by megalencephaly, demyelinization and multiple Rosenthal fibers. Specific magnetic resonance imaging (MRI) findings and genetic investigations are necessary to diagnose the disorder. Signs of leukodystrophy were found in the bilateral white matter on a brain MRI of our four-year-old patient. He had megalencephaly since birth. We use this case to discuss Alexander disease.

Bilateral renal hypoplasia and cystic dysplasia: a new phenotype of Thomas syndrome or a new syndrome?

Thomas syndrome is a rare syndrome including Potter sequence, renal anomalies, heart defects, cleft palate with other oropharyngeal anomalies. Here, we report a newborn with Potter sequence, bilateral renal hypoplasia and cystic dysplasia, multiple cardiovascular malformations, long large ears, frontal bossing, small lips, partial simple toe syndactyly, and cleft palate. To our best knowledge, this patient may be considered as a new variant of Thomas syndrome or a new syndrome.

Renal zinc clearance/glomerular filtration rate ratio as an indicator of marginal zinc deficiency associated with iron deficiency in childhood.

Objective: To evaluate the usefulness of renal zinc clearance/glomerular filtration rate ratio (RClZn/GFR) as an indicator of marginal zinc deficiency that is generally associated with iron deficiency in childhood. Methods: Zinc status was evaluated in 36 iron-deficient children (22 boys and 14 girls) who ranged in age from 1 to 10 years using serum zinc concentration and UZn/Cr and RClZn/GFR ratios. The results were compared with the zinc status of 36 similar-aged healthy children (24 boys and 12 girls). Results: Serum zinc concentrations were 96.72 ± 2.13 µg/dL and 93.93 ± 1.95 µg/dL in iron-deficient and healthy subjects, respectively (p > 0.05). UZn/Cr ratios were 0.54 ± 0.04 µg/mg and 0.88 ± 0.04 µg/mg (p < 0.0001); RClZn/GFR ratios were 2.27 × 10−3 ± 0.20 and 3.32 × 10−3 ± 0.20 (p < 0.001) in iron-deficient and healthy subjects, respectively. Individual values of RClZn/GFR and UZn/Cr ratios correlated with hemoglobin (Hb) concentrations (r  =  0.34, p < 0.01 and r  =  0.26, p < 0.05). Data grouped according to the ranges of Hb concentrations and RClZn/GFR and UZn/Cr ratios fit the following equations: The statistically significant difference in UZn/Cr and RClZn/GFR ratios between groups indicates decreased urinary estimation of marginal zinc deficiency, whereas no change was observed in serum zinc concentrations. According to the regression equation, it can be postulated that the RClZn/GFR ratio is a linear function of Hb concentration and the UZn/Cr ratio. Conclusion: RClZn/GFR ratio was a reliable indicator for reduction in urinary zinc excretion; it estimated the marginal zinc deficiency associated with iron deficiency. The RClZn/GFR ratio can be calculated using one sample of blood and urine; thus it could serve as an alternative indicator of marginal zinc deficiency, especially in routine health care.