Hasan Basri Üstünbaş

Septic arthritis in childhood

Abstract Background: The purpose of the present study was to determine whether there was a difference between septic arthritis (SA) combined with osteomyelitis and SA alone with regard to clinical and laboratory findings, such as symptoms on admission, age, sex, joint involvement and isolated micro‐organisms, and a relationship between age and joint involvement in SA. In addition, we also aimed to determine the prognostic factors in SA.

Reference Body Mass Index Curves for Turkish Children 6 to 18 Years of Age

AIM To determine reference body mass index (BMI) curves for Turkish children 6 to 18 years old and to compare with BMI in other countries. METHODS A cross-sectional study conducted in Kayseri, Turkey. A total of 5,727 children (2,942 girls, 2,785 boys) aged between 6 and 18 years were selected to construct a reference curve using LMS method. RESULTS BMI age reference charts of Turkish children were constructed. The 50th percentile curve of Turkish girls is lower than Italian and Turkish girls in The Netherlands but higher than Iranian girls. The 50th percentile curve of Turkish boys is lower than Italian and Turkish boys in The Netherlands and similar to Iranian boys after 13 years of age. CONCLUSION BMI references of Turkish children are lower than in South East Europe, UK and North American populations, but higher than in Central European and Scandinavian countries.

Amitraz poisoning in children: Clinical and laboratory findings of eight cases

Amitraz poisoning is a rare disorder characterised by central nervous system and respiratory depression, bradycardia, hypotension, hypothermia, hyperglycemia, vomiting, convulsion and glycosuria. In this study, eight pediatric patients with amitraz poisoning were presented. This study revealed that clinical manifestations of poisoning by oral and dermal route emerged within 30- 120 min and that central nervous system depression which is the most important sign resolved with 8-18 h and others 36-48 h. All cases were discharged as recovered after 48 h. To our knowledge only six cases have been reported in the literature. Because of the limited information in the literature, the cases were reported.

Percentiles and mean values for neck circumference in Turkish children aged 6-18 years.

Aim:  To provide neck circumference (NC) percentiles and mean values for Turkish children and to investigate their significance in clinical and epidemiological use.

Anthropometric risk factors for elevated blood pressure in adolescents in Turkey aged 11-17.

To investigate the relationship between anthropometric parameters and elevated blood pressure in adolescents, we measured blood pressure (BP), height, weight, triceps skinfold (TSF) thickness, waist circumference (WC), and mid-upper-arm circumference (MUAC) in 2,860 student volunteers aged 11–17 years in Kayseri, Turkey. Waist-to-height ratio (WHtR), waist-to-arm-span ratio (WASR), body mass index (BMI), arm-fat area (AFA), and fat percentage (FP) were also calculated. Participants were divided into two groups: hypertensive [systolic blood pressure (SBP) or diastolic blood pressure (DBP) ≥ 95th percentiles, n = 246] and normotensives (SBP or DBP < 95th percentiles, n = 2614). Multiple logistic regression models were produced within these groups for the examined risk factors, and cutoff points were investigated for SBP or DBP ≥ 95th percentiles using receiver operating characteristics (ROC) analysis. BMI, WC, WHtR, WASR, MUAC, and BMI had statistically significant cutoffs among boys. Whereas BMI, WHtR, WASR, WC, MUAC, AFA, and TSF were statistically significant for girls younger than 15, only BMI and WC were statistically significant for participants older than 15. The independent risk factors for elevated BP were determined according to BMI and WC. Although several anthropometric measurements were significant in our participants, BMI and WC were significant among all participants irrespective of age and sex.

Pulmonary complications in patients with staphylococcal sepsis

Abstract Background: The aim of the present study was to determine the pulmonary findings in patients with sepsis caused by Staphylococcus aureus.

Age references for the arm span and stature of Turkish children and adolescents

Background: Arm span reference values need to be determined in screening for certain clinical conditions. Aim: To determine arm span reference values for screening purposes in children and adolescents. Subjects and methods: Children and adolescents aged 6–17 were selected according to socio-economic levels. Age, pubertal period and sex-specific height and arm span are presented as means and standard deviation. Construction of the centile curves was performed using LMS software; the 3rd, 50th and 97th percentiles of each sex were compared. Results: A total of 5358 primary and secondary school students (2737 girls, 2621 boys) were sampled for this study. Centile curves for both genders and linear regression equations to predict height from arm span were produced (height = 13.4396 + 0.9037(arm span); r =0.95 for boys and height = 16.4181 + 0.8865 (arm span); r =0.93 for girls). The correlation between arm span and height (r =0.83 p=0.001) was high and significant through ages 6–17. Conclusion: The findings provide a comparison of height and arm span for clinical purposes in critical percentiles (3rd, 50th and 97th), although these findings suffer from a lack of longitudinal examination to show the progress of these two anthropometric measurements.

Change in waist circumference over 3 years in Turkish children and adolescents

Abstract Aim: To observe change in waist circumference (WC) over 3 years in children and adolescents and to compare these data with local and international references. Subjects and methods: The data of the second study determining the anthropometric measurements of Turkish children and adolescents (DAMTCA-II) were used to calculate WC percentiles. A total of 4234 children and adolescents aged 6–17 years (1890 boys and 2344 girls) were enrolled. The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th and 97th percentiles and z-scores were computed by the LMS Method. Results: The mean WC was significantly higher in boys than in girls in 12.5, 13 and 15–17 year old children (p < 0.001). The prevalence of central obesity (WC ≥ 90th percentile) was 13.5% (14.3% in boys and 12.9% in girls, respectively). There was no significant difference in prevalence of abdominal obesity, between each gender (p = 0.179) and age group from 6–17 years (p = 0.590). In a comparison with the available contemporary international references, the 50th percentiles of these references were similar to those in Bulgaria, but markedly higher than those of Malaysian children and of Chinese children living in Hong Kong. Conclusions: The prominent finding of this study was the significant increase in WC percentiles in a short time in both genders. In addition, the WC references are similar to other regional references, but significantly higher than those of East Asia.

Cutaneous manifestations in childhood staphylococcal sepsis.

In this article, the clinical and laboratory findings of six (15%) cases of cutaneous manifestations of 39 patients with sepsis caused by Staphylococcus aureus (S. aureus) were reviewed retrospectively. Our purpose was to determine the cutaneous manifestations in patients with sepsis caused by S. aureus. In our study, four patients had maculopapular and/or petechial/purpuric rashes, and two had erythematous lesions (one of them also had pustular lesions, and the other had furuncles). Aside from these, all patients had one or more systemic involvement such as bronchopneumonia, arthritis, osteomyelitis, or cardiac involvement. In conclusion, our findings suggest that there are no skin findings specific to staphylococcal sepsis and that pulmonary infections appear to have a high correlation with cutaneous findings, because all of our patients had evidence of bronchopneumonia. The mortality of staphylococcal sepsis associated with cutaneous findings appears to be high.

Exophthalmometric References of 7-18 Year-old Children in Kayseri, Turkey

AIM To produce age and gender specific exophthalmos references for Turkish children aged 7-18 years old. STUDY DESIGN This was a preliminary cross-sectional study. Data were obtained from the second study of the Determination of Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA II). A Hertel exophthalmometer was used and age and gender specific standard deviations (SD) and percentiles were calculated. RESULTS The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th 97th percentiles of right and left eye protrusion, and the mean and SD for each age and gender were calculated. In comparison of eyes and genders: Protrusion in the right eye was 14.81 (1.68), and 14.65 (1.67) in the left eye for boys. Protrusion in the right eye was 14.95 (1.68) and 14.75 (1.67) in the left eye of girls. In both genders the difference in protrusion of the two eyes was statistically significant (p <0.001). Exophthalmometric measurements were compared for pubertal periods by one-way analysis of variance and a significant difference was found in exophthalmos between pubertal periods for both eyes and gender (p <0.001). CONCLUSIONS Age and gender specific references for exophthalmia provide information for both clinical decision process and screening in describing abnormal or pathological conditions resulting in exophthalmos.