Mehmet Demirdöven

C-reactive protein and procalcitonin during febril attacks in PFAPA syndrome

OBJECTIVES To assess the levels of procalcitonin (PCT) and C-reactive protein (CRP) in children diagnosed with PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) during their febrile attacks. METHODS 23 patients with diagnosis of PFAPA included into the study prospectively during a three years period. In these patients, CRP and PCT values were recorded during 78 febrile episodes. Furthermore, 20 patients with diagnosis of pneumonia were chosen as a control group and their CRP and PCT values were measured. Normal reference values for CRP and PCT were 0-10 mg/L and 0-0.5 ng/mL, respectively. RESULTS Mean CRP and PCT values of patients with PFAPA were 94.8±71.6 mg/L and 0.29±0.14 ng/mL, respectively. In control group, mean CRP value was 153.2±26 mg/L and PCT was 1.59±0.53 ng/mL. CRP and PCT were high in control group. CRP was detected high and PCT was normal in PFAPA. Compared to control group, in PFAPA group, CRP values were not significantly (p>0.05) and PCT values were significantly lower (p<0.001). CONCLUSION During febrile episodes in the patients with diagnosis of PFAPA, CRP values were substantially elevated, whereas PCT values were within normal levels. Concomitant assessment of CRP and PCT in addition to clinical diagnostic criteria may be of help in making diagnosis and distinguishing febrile attacks from infections. However, studies in larger groups are required.

Retinopathy of prematurity: incidence, risk factors, and evaluation of screening criteria.

BACKGROUND/AIM The goal of this study was to investigate the incidence of retinopathy of prematurity (ROP) and the relationship between risk factors and disease in premature newborns in our neonatal intensive care unit. MATERIALS AND METHODS A total of 219 premature subjects were retrospectively evaluated for retinopathy. Demographic information, clinical data, and risk factors were reviewed. RESULTS The gestational ages of the infants included in the study ranged between 25 and 36 weeks, and the birth weights ranged between 670 and 4460 g. In this study, the incidence of ROP was 20.1% (44) in preterm infants: 16 had stage 1 (36.4%), 15 had stage 2 (34.1%), 11 had stage 3 (25%), 1 had stage 4 (2.3%), 1 had stage 5 (2.3%), and 6 had plus (+) disease (7.2%). The risk factors associated with the development of ROP included low birth weight, ventilation treatment, bronchopulmonary dysplasia, and maternal preeclampsia. The risk factors were analyzed with logistic regression analysis. The odds ratios were 5.952 (95% confidence interval [CI]: 2.030-17.447), 20.070 (95% CI: 4.213-95.600), 5.879 (1.916-18.037), and 3.200 (95% CI: 1.002-11.535), respectively. CONCLUSION In this study, birth weight, ventilation treatment, bronchopulmonary dysplasia, and maternal preeclampsia were the most important risk factors for the development of ROP.

Smith-Lemli-Opitz Syndrome: A Case with Annular Pancreas

Smith-Lemli-Opitz syndrome is an autosomal recessive disease of cholesterol metabolism. It is a multiple malformation syndrome with typical dysmorphic features such as bitemporal narrowing, ptosis, epicanthus, microcephaly, micrognathia, and cardiovascular, skeletal, urogenital, and gastrointestinal anomalies. This report presents a typical case of Smith-Lemli-Opitz syndrome with annular pancreas which is an unreported gastrointestinal abnormality.

The Effects of Inhaled β-Adrenergic Agonists in Transient Tachypnea of the Newborn

Aim. To investigate the efficacy of an inhaled β-adrenergic agonists in transient tachypnea of the newborn (TTN). Method. We retrospectively analyzed a cohort of 51 term infants (Group 1) and 37 term infants (Group 2) monitored in the newborn intensive care unit diagnosed with TTN. Infants in Group 1 received humidified oxygen alone, and infants in Group 2 were administered the inhaled β-2 agonist plus humidified oxygen. Results. TTN clinical respiratory assessment, respiratory rate, oxygen saturation values, need for supplemental oxygen therapy, blood gas PH, PO2, and duration of hospitalization were significantly improved in infants in Group 2 as compared with infants in Group 1 (P < .05). No statistically significant difference was observed with regard to blood glucose, potassium, heart rate, and PCO2 (P > .05). Conclusion. Inhaled β-adrenergic agonist added to humidified oxygen was found to improve clinical and laboratory parameters. We believe that further studies should be conducted with larger groups to demonstrate the efficacy of β-2 agonists in TTN patients.

Our results for five years of rotavirus vaccination

We aimed to evaluate the results of 5 years of rotavirus vaccination experience and compare the effects of monovalent and pentavalent vaccines. This retrospective study included 2345 children vaccinated in a trial that was held between January 2007 and January 2012. Information was obtained on whether the patient was administered the monovalent or pentavalent vaccine, whether he/she had rotavirus gastroenteritis after the vaccination, and whether he/she was treated as an outpatient or an inpatient. This information was obtained from the computer records and, in cases where information was lacking, the families were called to obtain missing details. In all patients with complaints of diarrhea, rotavirus antigen analysis was done with a rapid immunochromatographic stool test. The age range of the children was 3–60 months. Of the patients included in the study, 1270 (54%) were female and 1075 (46%) male. The monovalent vaccine was administered to 1700 (72.5%) children, while the pentavalent vaccine was administered to 645 (27.5%) children. After administration of the vaccine, no major complications were reported. Symptomatic rotavirus gastroenteritis was detected in 4 % of vaccinated children. No patients died due to rotavirus infection. There was no statistically significant difference between the vaccines in terms of the incidence of rotavirus gastroenteritis and the number of children who were hospitalized or received outpatient treatment (P > 0.05). Symptomatic rotavirus gastroenteritis was detected in only 4 % of the vaccinated children in our study. Moreover, there is no significant difference in the protection offered by the monovalent and pentavalent vaccines.

Doğumsal göz hastalıklarının erken tanısında kırmızı yansıma testinin Brückner etkinliğinin değerlendirilmesi

Amac: Yenidogan ve sut cocuklarinda kirmizi yansima testinin Bruckner tarama sonuclarini degerlendirmek Gerec ve Yontem: Calismaya Ocak 2007 ve Ocak 2010 tarihleri arasinda Ozel Sema Hastanesi rsquo;nde dogan ve Cocuk Klinigi tarafindan izlemi yapilan 2718 yenidogan ve sut cocugu alindi Tarama islemi 2 8 hafta arasinda duzenli kontrollerde oftalmoskopla yapildi Kirmizi yansima testi Bruckner alinamayan bebekler Goz Klinigi rsquo;ne gonderildi ve risk etmenleri arastirildi Calisma icin etik kurul onayi alindi 15 01 2007 21 Bulgular: Tarama yapilan bebeklerin 2715 rsquo;inde oftalmoskop muayenesinde kirmizi yansima testi alindi 99 8 Iki bebekte 0 07 iki tarafli bir bebekte ise tek tarafli 0 02 kirmizi yansima testi alinamadi Iki tarafli kirmizi yansima testi alinamayan bebeklerde ayrintili goz muayenesinde iki gozde katarakt tek tarafli kirmizi yansima testi alinmayan bebekte ise retinoblastom saptandi Risk etmeni arastirildiginda; iki tarafli katarakti olan bebeklerden biri Down sendromu idi digerlerinde her hangi bir risk saptanmadi Cikarimlar: Gorme kayiplarinin onlenmesi ve tedavinin basarisi icin tum yenidogan ve sut cocuklarinda kirmizi yansima testinin duzenli muayenenin bir parcasi olarak cocuk uzmanlari ve birinci basamak doktorlari tarafindan yapilmasinin gerekliligini vurgulamak istedik Turk Ped Ars 2012; 47: 165 6

Pneumatic reduction in the treatment of childhood intussusception cases

Intussusception that is defined as insertion of proximal intestine into distal segment is the second most common acute abdomen pathology after appendicitis. In this retrospective study, we evaluated the patients presented with intussusception and the results of pneumatic reduction. A retrospective analysis of files and operation logs of patients with intussusception from 2007 to 2011 were done. In this study, 13 male (72,2%) and 5 female (27,8%), totally 18 patients were analyzed. Mean age was 20,36 months (6,5-95 months). The most common clinical presentations were abdominal pain, vomiting, bloody stool and irritability and duration of complains were 6-52 hours. Although in all patients signs of intussusception were found on abdominal ultrasound examination, in 8 (44%) patients abdominal mass was detected on physical examination. In 15 (83,3%) patients pneumatic reduction was successfully performed and manual reduction was done in 3 (16,7%) patients. In conclusion, abdominal ultrasound that was performed in patients presented with abdominal pain and vomiting may affect the rate of early diagnosis of intussusception. In these patients, pneumatic reduction, as a first choice of treatment, can be carried out easily and successfully.

A Mother with Green Breastmilk Due to Multivitamin and Mineral Intake: A Case Report

It is a globally accepted fact that breastfeeding reduces infant mortality and morbidity, optimizes infant growth, is superior to other forms of nutrition for infants, and has economic advantages for the family and the country. This case study reports a new mother who stopped breastfeeding her baby because her breastmilk was green. When her second child was born, her milk came in green, and a consultation was requested from pediatrics and infectious diseases. A physical examination and laboratory tests revealed that the abnormal color of her breastmilk was related to multivitamin intake. The patient was advised to continue breastfeeding despite the odd color. Although clinical specialists know that the color of breastmilk can change with the ingestion of certain medications and foods, mothers are usually unaware and may unnecessarily terminate breastfeeding.

A Mild Chest Trauma in an Infant who Developed Severe Pulmonary Hemorrhage

Chest trauma, an important cause of morbidity and mortality, is the second most common cause of death in children under four years of age. Due to the different anatomy and physiology of the respiratory system in childhood, the injuries and consequences of chest trauma are also dissimilar. A seven-month-old male infant presented to the emergency clinic with cyanosis and respiratory distress. His medical history revealed that he had been found trapped behind his bed in a cyanotic state two hours earlier. Although physical examination revealed no signs of trauma, respiratory distress and hemorrhagic secretions indicated pulmonary hemorrhage or contusion. This preliminary diagnosis was confirmed by thoracic tomography. There was complete recovery following 48-hour oxygen and medical treatment. Even after mild injuries, the fact that severe pulmonary hemorrhages and contusions may develop without a trace of trauma should be kept in mind.