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Accuracy of Skeletal Age Assessment in Children From Birth to 6 Years of Age With the Ultrasonographic Version of the Greulich-Pyle Atlas

Objectives. For the evaluation of skeletal age, the methods of Greulich‐Pyle and Tanner‐Whitehouse are generally used in clinical practice. Our investigation was undertaken to determine whether the ultrasonographic version of the Greulich‐Pyle atlas is capable of assessing skeletal age. If so, we aimed to describe the standards for the ultrasonographic version of the Greulich‐Pyle atlas for each year during the first 6 years of life. Methods. Ninety‐seven subjects underwent left hand and wrist radiography and ultrasonographic examination for bone age assessment during a 1.5‐year study. Estimated bone ages derived from the plain radiography and “hand and wrist ultrasonography charts” interpreted by use of the Greulich‐Pyle atlas were compared statistically. Results.The estimated bone ages from plain radiography and hand and wrist ultrasonography charts interpreted by use of the Greulich‐Pyle atlas were significantly correlated; 71.1% of male patients had the same age in both methods, and in 84.4% of patients, the difference was less than 6 months. In 65.5% of female patients, both methods revealed the same age, and in 88.5% of them, the difference was less then 6 months. Conclusions. The ultrasonographic version of the Greulich‐Pyle atlas can be used to estimate bone age even in ultrasonography departments. This method is highly correlated and a valid alternative to plain radiography for bone age estimation. This enables estimation of skeletal age in ultrasonography departments easily without exposing the patient to radiation.

Hypertension induced reversible posterior leukoencephalopathy syndrome: a report of two cases.

Reversible posterior leukoencephalopathy syndrome (RPLS) is a recently described disorder with typical radiological findings of bilateral grey and white matter abnormalities in the posterior regions of the cerebral hemispheres. The majority of patients with RPLS are adults and it is rare in children. In this report, two patients with RPLS are presented. In the first patient the primary diagnosis was acute post-streptococcal glomerulonephritis, a known cause of RPLS both in adults and in children. The second patient had Henoch Schönlein purpura. Conclusion:These patients are presented to highlight the importance of reversible posterior leukoencephalopathy syndrome. As the spectrum of associated diseases is diverse, paediatricians must be aware of this syndrome in order to initiate appropriate management.

Children and firearms in Turkish homes.

BACKGROUND Unintentional firearm injuries are an important cause of preventable deaths and disabilities among children. Keeping firearms at home and letting children to see or touch them increases the risk of injury. METHODS This cross-sectional study was conducted to estimate the extent of the firearm problem in an Anatolian province in Turkey. A random sample of families were approached and were asked to answer a series of questions completed by research assistants. RESULTS In 974 randomly selected households, there were 2129 children aged less than 18 years, 11.1% of the fathers have a job in the firearms industry or in the security sector, and 12.3% of the households kept a firearm at home. Only 25.6% of the firearms were kept in a safe place, and 29.3% of the firearms and ammunition were kept separately. Overall, 70.9% of the children whose parents have firearms saw the firearm and 27.2% had handled it. CONCLUSIONS Results of this study pointed to the urgent need for preventive measures for the physical separation of guns from children. The establishment of effective firearms safety programmes requires an understanding of the culture and routine behaviours of the target population.

Plasma free carnitine levels in 0-12-month-old infants in relation to feeding styles

This study was planned to determine the blood carnitine levels of children aged 0-1 year in Kirikkale. Blood samples were taken on Guthrie cards and plasma free carnitine levels were analyzed by tandem mass spectrometry. The mean free carnitine level was 25.12 +/- 10.1 micromol/L (10.1-49.5 micromol/L). To assess the plasma free carnitine levels according to feeding style, babies were grouped as exclusively breastfed (n = 67, 49.3%), artificially fed (n = 24, 17.7%), and mixed fed (n = 45, 33%). The exclusively breastfed infants displayed the lowest free carnitine levels (p < 0.05). However, when this was analyzed in accordance with age, no significant change was observed in plasma free carnitine levels according to feeding style. Results of this study are important as they reveal an indication about the normal values of plasma free carnitine in Turkish infants and their relationship to feeding styles.