Nesrin Ceylan

Report of Eight Infants with Acute Infantile Hemorrhagic Edema and Review of the Literature

Acute infantile hemorrhagic edema (AIHE) is a cutaneous leukocytoclastic vasculitis, clinically characterized by the symptom triad of fever, large purpuric skin lesions, and edema. The clinical picture has a violent onset, a short benign course, and spontaneous complete recovery. In this article, we present eight patients who were admitted with rashes on the skin and edema on the eyelids and extremities, and were diagnosed with AIHE according to their clinical and histopathological features (immunohistological study was also performed in three of them). Our purpose was to emphasize that, aside from Henoch‐Schönlein purpura, meningococcemia, septicemia, and purpura fulminans, AIHE benign disorder should also be considered in the differential diagnosis to determine the clinical course and treatment protocol in patients with purpuric rashes.

Clinical manifestations and laboratory findings of 496 children with brucellosis in Van, Turkey

Brucellosis is the most common zoonotic disease worldwide and remains an important human disease especially in developing countries. The aim of the present study was to evaluate clinical manifestations and laboratory findings of childhood brucellosis in Van province of Eastern Turkey. To our knowledge, this is the largest series of childhood brucellosis reported in the literature.

Evaluation of Antimicrobial Resistance in Staphylococcus aureus Isolates by Years

Objective. Recently, community and hospital-acquired infections with Staphylococcus aureus have increased and raised antibiotic resistant isolates. In this study, we aimed to evaluate the antibiotic resistance profile of S. aureus isolates over several years in various clinical specimens from our hospital. Materials and Methods. S. aureus strains from 2009 to 2014 were isolated from various clinical samples at Yuzuncu Yil University, Dursun Odabas Medical Center, Microbiology Laboratory, and their antibiotic susceptibility test results were retrospectively investigated. The isolates were identified by conventional methods, and antibiotic susceptibility tests were performed by the Phoenix (Becton Dickinson, USA) automated system method according to Clinical and Laboratory Standards Institute (CLSI) standards. Results. A total of 1,116 S. aureus isolates were produced and methicillin-resistant S. aureus (MRSA) to 21% of all S. aureus isolates between 2009 and 2014. According to the results of susceptibility tests of all isolates of S. aureus, they have been identified as sensitive to vancomycin, daptomycin, linezolid, and levofloxacin. While the resistance rates to nitrofurantoin, quinupristin-dalfopristin, and trimethoprim-sulfamethoxazole were determined as 0.3%, 2.4%, and 6%, respectively, resistance rates to penicillin, erythromycin, rifampicin, gentamicin, and clindamycin were determined as 100%, 18%, 14%, 14%, and 11%, respectively. The highest percentage of methicillin resistance was determined as 30% in 2009, and the resistance was determined to have decreased in subsequent years (20%, 16%, 13%, 19%, and 21%) (p < 0.001). Conclusion. Currently, retrospective evaluations of causes of nosocomial infection should be done periodically. We think that any alteration of resistance over the years has to be identified, and all centers must determine their own resistance profiles, in order to guide empirical therapies. Reducing the rate of antibiotic resistance will contribute to reducing the cost of treatment.

An Extraordinary Cause of the Sucking Difficulty: Ecthyma Gangrenosum

Ecthyma gangrenosum is a cutaneous lesion often associated with pseudomonas aeruginosa bacteremia, even though it may develop without bacteremia and may originate from other bacterial and fungal organisms. Pseudomonas aeruginosa bacteremia or sepsis, which mainly affects immunocompromised patients, frequently occurs in hospitals. This lesion typically occurs on the extremities and gluteal and perineal regions. In this report we present a case of ecthyma gangrenosum in a premature newborn occurring secondary to pseudomonas sepsis causing sucking dysfunction due to tissue loss in the lip, soft palate, and tongue.

Investigation of the effect of the efficiency of noise at different intensities on the DNA of the newborns

Hearing loss can occur in newborns exposed to high-level noise; noise exposure can cause more physiological stress and can lead to DNA damage. This study was designed to determine DNA damage in newborn rats exposed to sound at different concentrations. For this purpose, 28 newborn (3-6 days old) rats were divided into four groups of 7 rats in each group (Control and Groups of 40 decibel (dB), 70 dB, and 110 dB]. In the experimental groups, 40 dB, 70 dB, and 110 dB (7.5-15 kHz) of sound was applied to the experimental groups for 30 min a day for 7 days. DNA damage levels in the serums obtained from this study were determined by the enzyme-linked immunosorbent assay (ELISA) method. According to this, it was determined that DNA damage in the group exposed to 110 dB showed a statistically significant increase (P < 0.05) compared to the compared to the control, 40 dB, and 70 dB groups. Related to the subject, it was concluded that DNA damage may occur in newborns exposed to 110 dB or higher sound in neonatal units, wards, and home environments with newborn babies. Mothers should be warned about this situation and noise should be kept under 110 dB volume in the environments with the newborns.

Tularemia characterized by cervical lymphadenopathy in an adolescent child

Francisella tularensis is a factor in gram-negative coccobacillus morphology and obligate aerobic, facultative intracellular property which causes significant infections in humans and animals. F. tularensis infections are seen more widely at the northern hemisphere (1). It is estimated that there are about 500,000 tularemia cases per year in the world (2). When written sources are analyzed, it is noted that tularemia cases have also increased and the infection has become an important public health problem in our country in recent years. According to the data of the Ministry of Health, although more than 1000 tularemia cases were reported in our country until 2005, the number of the cases reported between 2005-2009 after the change made in the announcement of the notifiable diseases in 2005 was reported as 1091 (3). Carrier or infected rodents play an important role in the epidemiology of the disease. Animals of this nature with secreted and extract factors can easily infect the environment and other living things. On the other hand, vectorial infection also occurs with the blood-sucking parasites. Clinical findings vary depending on the pathogenicity of the factor, the entry way to the body, the degree of systemic involvement, patients immune efficiency, and the timely diagnosis and treatment (4). Cases of tularemia that can be seen in a wide clinical spectrum are identified at six clinical forms including ulceroglandular, oropharyngeal, oculoglandular, glandular, typhoid and pneumonia. Oropharyngeal tularemia which is seen as the most common form in our country occurs with the infection of the agent with contaminated water and food by oral route (1). The formation of cervical mass that is frequently seen at the ABSTRACT

MORTAL BIR EPIDERMOLIZIS BÜLLOZA OLGUSU

Epidermolizis bulloza (EB), travmayi takiben olusan bullerle karakterize, kalitsal gecisli bir hastaliktir. EB’nin farkli tiplerinin olusumunda cildin bazal membran tabakasini olusturan proteinleri kodlayan genlerde cesitli mutasyonlar rol oynar. Doku ayrismasinin duzeyine gore, EB simpleks (EBS), “junctional” (JEB), distrofik (DEB) ve Kindler tip olmak uzere 4 tipe ayrilir. Nadir gorulen JEB tipi yenidogan doneminde yuksek mortaliteye sahiptir. 28 yasindaki saglikli annenin 2 gebeliginden, miadinda erkek bebek olarak spontan vajinal yol ile dogan olgumuza cilt biyopsisi ve klinik bulgular isiginda JEB tanisi kondu. Olgumuzun fizik muayenesinde, extremite, tirnak yapilarinin hipoplastik ya da dismorfik oldugu, ayak bileklerinden baslayan ve tum ayak ve ayak parmaklarini icine alan atrofik yapi, tum vucutta ve agiz mukozasinda yaygin bulloz lezyonlar gozlenmistir. Tedavide kismi duzelme gozlenmis olmasina ragmen, klinik tablosunda ani bozulma ve kardiyak arrest sonucu hasta kaybedildi. Epidermolizis bullozanin “junctional” tipinin prognozunun oldukca mortal oldugunu ve araya enfeksiyon girmeksizin ani kayiplarin olabilecegi akilda tutulmalidir.

Psychometric properties of the Turkish version of the Child PTSD Symptom Scale

OBJECTIVE Psychometric properties of the Turkish version of the Child PTSD Symptom Scale (CPSS) were examined in a sample of young individuals who experienced a severe earthquake. METHOD Subjects were 479 children and adolescents recruited from schools after 18 months of Van earthquake. Mean age was 12.83 (SD±1.88), ranging from 8 to 18. RESULTS Psychometric features were generally good for the CPSS. The original three-factor structure was replicated in this study. Internal consistency of the scale was good (ranged from α=.70 to α=.89 for total and subscale scores). The CPSS demonstrated good convergent validity with Child Post-Traumatic Stress Disorder Reaction Index scores as well as good divergent validity with the State and Trait Anxiety Inventory for Children and Child Depression Inventory. As an evidence for a good discriminant validity, the CPSS successfully distinguished high PTSD individuals from low PTSD individuals. CONCLUSION The CPSS had sound psychometric properties in a Turkish youth population.