Selim Dereci

Peripapillary retinal nerve fiber layer thickness in children with iron deficiency anemia.

Purpose. To evaluate peripapillary retinal nerve fiber layer (RNFL) thickness in children with iron deficiency anemia (IDA) in comparison with healthy controls and to investigate the correlation between peripapillary RNFL thicknesses and the hematologic parameters in these subjects. Methods. Forty eyes of 40 children with a diagnosis of IDA (anemic group) and 40 eyes of 40 age- and sex-matched healthy children (control group) were enrolled in this study. Peripapillary RNFL thickness measurements were performed using Cirrus HD optical coherence tomography (OCT). Results. Mean age of each group was 11.3±2.7 years. Average RNFL and RNFLs of superior and inferior quadrants were significantly thinner in the anemic group than in the control group (p=0.006, p=0.005, and p=0.005, respectively). In addition, average peripapillary RNFL thickness and RNFL thicknesses of superior, inferior, and temporal quadrants were correlated with hemoglobin levels (r1=0.734, p1<0.001, r2=0.456, p2=0.005, r3=0.598, p3<0.001, r4=0.349, p4=0.037, respectively) in anemic group. Conclusions. We found that children with IDA had different peripapillary RNFL profile measured by Cirrus HD spectral-domain OCT. We caution ophthalmologists when they measure RNFL thickness in children to diagnose glaucoma or other neuro-ophthalmic disorders.

Prevalence and genotype distribution of rotaviruses in children with gastroenteritis in Rize province

Determination of the distribution of rotavirus genotypes is essential for understanding the epidemiology of this virus responsible for nearly half a million of deaths in patients with gastroenteritis worldwide. In the present study, we aimed to genotype the rotavirus strains isolated from diarrheal stool samples in children under 5 years old. A total of 1297 fecal samples were collected, and rotavirus antigen was detected in 73 of these samples. Antigen-positive samples were transferred to the Public Health Agency of Turkey, Molecular Microbiology Research Laboratory, and were tested for determination of genotypes G and P using semi-nested multiplex polymerase chain reaction method performed with consensus- and genotype-specific primers. Twelve specimens were found to be negative for rotavirus in genotyping method. All the positive-strains were in G1-4, G8-9, P(4), P(8), and P(9) genotypes. The most frequent GP genotype combinations were found to be G9P(8) in 21 strains (34.4%), G2P(4) in 14 strains (23.0%), and G1P(8) in 12 strains (19.7%). We found 10 distinct genotypes amongst a total of 61 strains. Among the strains isolated and genotyped in our study, 90.2% (55/61) and 67.2% (41/61) have already been included in the two existing commercial vaccines. In conclusion, these findings implicate the necessity of development of region-specific vaccines after evaluation of the local genotype distribution. Further studies on the large number of rotavirus strains would contribute to this process.

Status of vitamin D, antioxidant enzymes, and antioxidant substances in neonates with neonatal hypoxic-ischemic encephalopathy

Abstract Objective: To investigate the concentration of vitamin D (VD), glutathione peroxidase (GP), superoxide dismutase (SOD), malondialdehyde (MDA), and advanced oxidation protein products (AOPP) in neonates with hypoxic-ischemic encephalopathy (HIE). Material and methods: This study was performed prospectively in term neonates treated for HIE. Samples were collected from the neonates in study and control groups at 6–14 h and on day 5 of their lives for 25-OH vitaminD3, antioxidant enzymes including GP and SOD and oxidants substances including MDA and AOPP. Results: This study was performed with 31 term neonates with HIE and 30 healthy term neonates. Maternal VD level was statistically lower in the study group (9.8±6.8 ng/mL) than the control (16.4±8.7 ng/mL) (p = 0.002). SOD and MDA levels were significantly high, and VD level was significantly low in the study group on the first day of life (p = 0.001 and p = 0.028, respectively). SOD and GP levels were significantly high in the study group on day 5 (p < 0.05). VD was significantly low in the study group on day 5 and the proportion of subjects with VD below 5 ng/ml was significantly lower in the control group (p = <0.05). Conclusion: VD has neuroprotective and antioxidant properties. We detected VD levels were low in infants with HIE and their mothers. This finding may be useful for decreasing of brain damage.

Assessment of peripapillary retinal nerve fiber layer thickness in children with vitamin B12 deficiency

PurposeVitamin B12 deficiency is a worldwide problem. It affects all ages, including children. It is one of the most common nutritional disorders and can cause harmful effects on the nervous system. In this study, we compared the peripapillary retinal nerve fiber layer thickness (RNFLT) in a healthy control group with children with vitamin B12 deficiency. In our study, we aimed to evaluate the effect of vitamin B12 deficiency on the RNFLT in children with the optical coherence tomography (OCT) method.MethodsSixty-six children with a diagnosis of vitamin B12 deficiency (patient group) and 66 age- and sex-matched healthy children (control group) were enrolled in this prospectively designed study. Blood counts, vitamin B12 levels, folate levels, and full biochemical parameters were obtained for all the subjects in each group. Peripapillary RNFLT measurements were performed with Cirrus HD spectral domain OCT.ResultsThe thickness of the superior retinal nerve fiber layer (RNFL) in the vitamin B12 deficiency group was significantly lower than that of the control group (p = 0.037). Although the average thickness of the RNFL was lower in the patient group, there was no statistically significant differences (p = 0.216). In the vitamin B12 deficiency group, the average RNFL thickness and the superior RNFL thickness were significantly correlated with vitamin B12 levels (r1 = 0.353, p1 < 0.004 and r2 = 0.416, p2 = 0.001, respectively).ConclusionOur study showed that a deficiency in vitamin B12, elsewhere it is important for the development of the central nervous system, is associated with a reduction in the thickness of the superior RNFL.

Cystic Eechinococcosis in Childhood: Five-Years of Experience From a Single-Center.

OBJECTIVE To evaluate the clinical data and prognosis of cystic echinococcosis during a 5-year period who were followed by the pediatric clinics. METHODS Demographic, clinical, laboratory, and prognosis data of 34 patients with cystic echinococcosis obtained between 2009 to 2014 were retrospectively evaluated. Of these, 10 patients were excluded because of incomplete data or failure to follow up. RESULTS A total of 24 (12 males and 12 females) children were included the study. The mean ages of patients were 11.17 ± 3.71 (range, 5-17) years. The most common symptoms were abdominal pain (41.7%), cough (16.7%), and fatigue (12.5%). Localization of the parasite in the patients was determined to be as follows: liver (54.2%), lung (33.3%), and intraabdominal (4.2%). Multiorgan involvement was observed in 8.3% of the cases. Indirect hemagglutination test was positive in 13 (54.2%) patients at admission. All patients received treatment with albendazole. Seven patients were treated with puncture-aspiration-injection-re-aspiration (PAIR) (29.2%). Open surgery was performed in six patients (24.2%). One patient was treated with both PAIR and open surgery. CONCLUSIONS Cystic echinococcosis is a serious public health problem in developing countries. Hydatid cyst should be considered in the presence of suspicious radiological and clinical findings in endemic areas.

Foreign body ingestion in children.

AIM Foreign bodies ingested by the oral route enter into the gastrointestinal tract and are considered a significant health problem in the childhood. In this study, we evaluated the pediatric patients who presented to our hospital with the complaint of ingestion of foreign body. MATERIAL AND METHODS The hospital records of all children who presented to our clinic because of ingestion of foreign body between January 2008 and January 2015 were examined retrospectively. The complaints at admission, the types of foreign bodies ingested, the localization of the foreign body in the gastrointestinal tract and the approaches and treatment methods used were examined. RESULTS Thirty-six (56%) of 64 patients included in the study were male and 28 (44%) were female and the mean age was 5.7±4.6 years (10 months-17 years). Thirty eight (59%) of 64 children who were included in the assessment were below the age of five years. The most common complaint at presentation was parental recognition of the ingested object and dysphagia. The most commonly ingested foreign bodies included coins, sewing pins, safety pins and hairclips. Nail clipper detected in the stomach, sewing pin which penetrated through the duodenal wall and stuck to hepatic parenchyma were the first pediatric cases in the literature. Upper esophagus was the most common location for foreign bodies. Endoscopic examinations were performed in 55 of 64 children. CONCLUSIONS Early detection and treatment of ingested foreign bodies in the upper gastrointestinal system is important in terms of preventing possible complications. In our study, the most frequent foreign bodies detected in the upper digestive tract were coins and they were most frequently detected in the upper esophagus. Most of our patients were below the age of five years. Flexible endoscopic method was used commonly for treatment.

Gallstones in childhood: etiology, clinical features, and prognosis.

Aim The aim of this study was to determine demographic and clinical features in children diagnosed with gallstones, risk factors for gallstone formation, the effectiveness of ursodeoxycholic acid therapy, and the course of the disease. Materials and methods Patients aged 0–18 years were followed up for at least 6 months after the diagnosis of gallstones with ultrasonography and were evaluated retrospectively. Patients were evaluated with respect to age, sex, presenting symptoms, BMI, facilitating factors, accompanying diseases, family history of gallstones, history of ceftriaxone use, laboratory tests, ultrasonography findings and follow-up, and therapeutic approaches and results. Results The study was completed with 70 patients. Thirty-nine (55.7%) patients were females. The mean age of the patients was 9.3±5.29 (0.3–18) years. The mean age among females was statistically significantly higher than that among males (P=0.007). No risk factor for stone formation was encountered in 50% of cases, whereas a family history of gallstones was present in 17.1%. Use of ceftriaxone was present in 8.6% of cases, total parenteral nutrition in 10%, obesity in 5.7%, hereditary spherocytosis in 4.3%, and Down’s syndrome in 4.3%. The probability of dissolution of stones was 3.6 times higher in patients with stone sizes up to 5 mm [odds ratio (OR): 3.65, P=0.020], 3.9 times higher in those aged younger than 2 years (OR: 3.92, P=0.021), and 13.9 times higher in those with a single stone (OR: 13.97, P=0.003). Conclusion Our findings show that unknown causes are still prevalent in stone formation and that ursodeoxycholic acid exerts no effect on stone dissolution; however, diagnosis at younger than 2 years of age, a single stone, and small size of stone are factors affecting dissolution.

Deep neck abscess in neonatal period: case report and review of literature.

Deep neck abscess is very rare in neonatal period. We reported a deep neck abscess caused by methicillin-sensitive Staphylococcus aureus infection (MSSA) in a neonate. A 10-day male infant was admitted to our neonatal unit with the complaints of fever, irritability, and refused to food intake. Ultrasonography and magnetic resonance imaging revealed as an abscess in the neck. Needle aspiration from abscess revealed pus. Antibiotics and drainage were applied. We also reviewed the neonatal deep neck abscess reported in English literature and clinical presentation, risk factors, causing microorganisms, treatment, complication and outcome of deep neck abscesses were discussed.

Is Kiwifruit Allergy a Matter in Kiwifruit‐Cultivating Regions? A Population‐based Study

Although kiwifruit is known as a common cause of food allergy, population‐based studies concerning the prevalence of kiwifruit allergy do not exist. We aimed to determine the prevalence and clinical characteristics of IgE‐mediated kiwifruit allergy in 6–18‐year‐old urban schoolchildren in a region where kiwifruit is widely cultivated.

The nutritional status of hospitalized children: Has this subject been overlooked?

BACKGROUND/AIMS To determine the nutritional status of hospitalized children at the time of admission and to investigate the relationship between diagnosis and nutritional status. MATERIALS AND METHODS Body weight, height, triceps skinfold thickness, and mid-arm circumference were measured on admission and percentages of weight-for-age, weight-for-height, body mass index, mid-arm circumference, and triceps skinfold thickness were calculated. The nutritional status was evaluated using the Waterlow, Gomez, and other anthropometric assessments. RESULTS A total of 511 patients were included in the study with a mean age of 5.8±4.9 years. Malnutrition was determined in 52.7% of patients according to the Waterlow classification. Mild malnutrition was determined in 39%, moderate in 12%, and severe in 1.7%, with the characteristics of acute malnutrition in 23.9%, acute-chronic in 7.3%, and chronic in 21.5%. The highest rate of malnutrition was in the 0-2 years age group (62.3%). According to the Gomez classification, malnutrition rate was determined as 46.8%. The rates of malnutrition in malignant, gastrointestinal, and infectious diseases were 60%, 59.8%, and 54.5%, respectively. CONCLUSION The prevalence of malnutrition in hospitalized children was noticeably high. The nutritional evaluation of all patients and an early start to nutritional support could provide a significant positive contribution.