Hayri B. Toksoy

Intravenous Immunoglobulin in the Treatment of Salmonella Typhimurium Infections in Preterm Neonates

The purpose of this study was to determine the role of intravenous immunoglobulin (IVIG) administration in preterm neonates with S. typhimurium infection. A randomized trial of 47 preterm neonates with intestinal or extraintestinal S. tymphimurium infection was performed. Neonates were randomly divided into two groups: 22 neonates were only given cefoperazone (group 1); 25 neonates were given cefoperazone plus IVIG (group 2). IVIG was given at a dose of 500 mg/kg on days 1, 2, 3, and 8 after entry into the study. Following treatment, bacteremia, complications, mortality rate, recovery time, and duration of antimicrobial therapy were evaluated in two groups. Bacteremia was found in 31.4% in group 1 and 8% in group 2 (P<.05); complications developed in 81.8% in group 1 and 16% in group 2 (P<0.01); mortality was 40.9% in group 1 and 12% in group 2 (P<.05). Recovery took 15 days in group 1 and 8 days in group 2 (P < .01). The duration of antimicrobial therapy was 20 days in group 1 and 14 days in group 2 (P<.01). We conclude that IVIG treatment in combination with antibiotics in preterm neonates with S. typhimurium infection reduces the complications, mortality rate, and duration of therapy.

ANALYSIS OF PEDIATRIC THROMBOTIC PATIENTS IN TURKEY

This study analyzes the data of thrombotic children who were followed up in different pediatric referral centers of Turkey, to obtain more general data on the diagnosis, risk factors, management, and outcome of thrombosis in Turkish children. A simple two-page questionnaire was distributed among contact people from each center to standardize data collection. Thirteen pediatric referral centers responded to the invitation and the total number of cases was 271. All children were diagnosed with thromboembolic disease between January 1995 and October 2001. Median age at time of first thrombotic event was 7.0 years. Of the children 4% of the cases were neonates, 12% were infants less than 1 year old, and 17% were adolescents. Thromboembolic event was mostly located in the cerebral vascular system (32%), deep venous system of the limbs, femoral and iliac veins (24%), portal veins (10%), and intracardiac region (9%). Acquired risk factors were present in 86% of the children. Infection was the most common underlying risk factor. Inherited risk factors were present in 30% of the children. FVL was the most common inherited risk factor. Acquired and inherited risk factors were present simultaneously in 19% of the patients. Eleven children had a history of familial thrombosis. Due to the local treatment preferences, the treatment of the children varied greatly. Outcome of the 142 patients (52%) was reported: 88 (62%) patients had complete resolution, 47 (33%) had complications, 12 (9%) had recurrent thrombosis, and 34 (24%) died. Three children (2.1%) died as a direct consequence of their thromboembolic disease. The significant morbidity and mortality found in this study supports the need for multicentric prospective clinical trials to obtain more generalizable data on management and outcome of thrombosis in Turkish children.

Asymptomatic hypercalciuria : Prevalence and metabolic characteristics

Hypercalciuria is of continuing interest as a risk factor for kidney stones in children. We screened 592 healthy Turkish children (308 boys, 284 girls, aged 3 month-16 years) for hypercalciuria by measurement of urinary calcium/creatinine (UCa/Cr) ratio in the second-morning urine samples. Hypercalciuria was noted in 17 children (2.9 %), 9 of them were boy and 8 of them were girl. Oral calcium-loading test could only be done in 7 children who were diagnosed as having hypercalciuria, and it revealed absorptive hypercalciuria in 2 cases and renal hypercalciuria in no cases. The frequency of a family history of urolithiasis in asymptomatic hypercalciuric children was 50%. Median UCa/Cr ratios and urinary magnesium/creatinine (UMg/Cr) ratios were 0.11 and 0.10 and the 97th percentiles were 0.32 and 0.23 respectively. The UCa/Cr ratio in second-morning urine samples was correlated with the UMg/Cr ratio (r = 0.44) and was independent of age and sex.

Gestational age assessment in preterm neonates weighing less than 2500 grams.

Postnatal assessment of gestational age (GA) in preterm neonates is traditionally performed using the methods of Dubowitz and Ballard. Dubowitz et al. in 1970 Ballard et al. in 1977 and in 1991 Tuncer et al. in 1982 introduced a scoring system for GA determination in an attempt to improve the accuracy of assessment. Our study has been designed to determine the accuracy of Dubowitz Ballard and Tuncer methods in a sample of low birth weight preterm neonates. Neonates included in this study are 91 preterm singletons with GA ranging from 28 to 38 weeks delivered during a 2-year period. All neonates met the following criteria: 1) birth weights less than 2500 g; 2) reliable GA by last menstrual period (LMP); and 3) complete Dubowitz Ballard and Tuncer neonatal examination performed. All Dubowitz Ballard and Tuncer examinations were done in the first 30-42 h of life by one of three pediatricians masked to the presumed GA. (excerpt)

Yenidoğan Döneminde Hematolojik Bulgularla Ortaya Çıkan Bir Fanconi Anemisi Olgusu

Familial hemophagocytic lymphohistiocytosis was diagnosed in a three and a half month old infant with anemia hepatosplenomegaly and intractable fever Three siblings had died due to unknown causes The diagnosis was verified with autopsy Clinical and laboratory findings of the case are discussed in the light of literature Key words: Familial Hemophagocytic Lymphohistiocytosis

Sivas Yöresinde Preterm Bebeklerde Peri İntraventriküler Kanama

The aim of this study was to determine the prevalence of peri intraventricular hemorrhage in pretem infants aged between 28 37 gestational weeks in Sivas province The study was carried out on 47 preterm infants in the unit of neonatology of Cumhuriyet University Hospital The mean gestational age of the study group was 34 2±2 4 weeks Birth weights ranged from 600 gr to 2350 gr mean 1443±429 gr Of the 47 preterm infants 44 were evaluated by cranial ultrasonography and 3 were evaluated by cranial computed tomography Perintraventricular hemorrhage was detected in 19 of the 47 infants 40 4 The gestational ages and birth weights of the infants with peri intraventricular hemorrhage were significantly low Respiratory distress syndrome was the statistically significant factor among the neonatal factors in relation to peri intra ventricular hemorrhage The mortality rate of peri intraventricular hemorrhage was 78 9 percent Key words: Peri Intraventricular Hemorrhage Cranial Ultrasonographyx

Bir Lesch Nyhan Sendromu Olgusu

Lesch Nyhan sendromu purin metabolizmasinin X e bagli resesif kalitilan bir bozuklugudur Bozuklugun sebebi hipoksantin guanin fosforibozil transferaz enziminin eksikligidir Hastalikta hiperurisemi selfmutilasyon koreoatetosis spastisite ve mental retardasyon ile karakterizedir Bu yazida mental retardasyonu selfmutilasyonu spastisitesi olan bir Lesch Nyhan sendromu olgusu ve ilgili literatur gozden gecirildi Anahtar kelimeler: Lesch Nyhan Sendromu Selfmutilasyon Purin Metabolizmasi