Tanju Çelik

Comparison of the Relative Renal Function Calculated with 99mTc-Diethylenetriaminepentaacetic Acid and 99mTc-Dimercaptosuccinic Acid in Children.

The aim was to compare the relative renal functions measured with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) and technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA) in children with renal diseases. Relative renal function of 128 children who applied to three hospitals from 2009 to 2011 were analyzed retrospectively. The mean value measured with 99mTc-DTPA and 99mTc-DMSA were 51.58 ± 14.95 and 51.96 ± 14.99 for the right kidney, 47.87 ± 15.27 and 47.94 ± 15.17 for the left kidney, respectively. A significant positive correlation was found between the relative renal functions (r = 0.963, P < 0.001). In Bland-Altman plots, the mean difference between two methods was 0.7 and the correlation limits were between 10.1 and-10.8. As a result, although 99mTc-DMSA is accepted as the most reliable method for the determination of relative renal function, 99mTc-DTPA can be another choice for the calculation of relative renal function without a complementary DMSA scan particularly in pediatric patients who require renogram curve and GFR calculations.

Mean platelet volume can predict cerebrovascular events in patients with Sickle Cell Anemia

Objective: The purpose of this study was to determine the impact of mean platelet volume (MPV) on the frequency and severity of vaso-occlusive and cerebrovascular events in patients with sickle cell anemia (SCA). Methods: The 238 cases diagnosed with SCA were evaluated retrospectively with respect to the occurrence of painful crisis for the previous year. The incidence, severity and type of the vaso-occlusive crises of the patients with SCA between March 2010 and March 2011 were recorded. The last MPV values in patients who were free of erythrocyte transfusion for the last three months and who had no current vaso-occlusive crises were evaluated. All the patients were grouped according to the frequency of the crises for the previous year preceding the data collection. Group 1: 1 to 3 crises, Group 2: 4 to 5 and Group 3: 6 or more crises annually. Results: In accordance with the results obtained during the evaluation of the cases diagnosed with sickle-cell anemia, MPV value was found to be significantly higher in patients with cerebrovascular events. Also MPV values increased with increasing incidence of the crises (r=0.297) (p=0.001). Conclusion: One of the contributing factors for this clinical heterogeneity may be related to the MPV values in patients with sickle cell anemia. The higher MPV values may be an early predictor of future cerebrovascular events in patients with sickle cell anemia and may require close follow-up and additional measures.

Psychiatric problems in children and adolescents with sickle cell disease, based on parent and teacher reports.

Objective: This study aimed to investigate the occurrence of psychiatric problems in children and adolescents withsickle cell disease (SCD). Material and Methods: The Child Behavior Checklist for ages 4-18 years (CBCL/4-18), Conners’ Parent RatingScale (CPRS), Conners’ Teacher Rating Scale (CTRS-R), and The Turgay DSM-IV Based Child and Adolescent BehaviorDisorders Screening and Rating Scale, clinician and parent forms (T-DSM-IV-S) were given to the caregivers and teachersof 31 children with SCD aged between 7-18 years and the caregivers and teachers of 34 age matched controls with irondeficiencyanemia. Results: The SCD patients had higher scores on all 4 of scales. Among the subscales, internalizing problems, andattention problems were more prominent in the SCD patients. Conclusion: Children and adolescents with SCD appear to have an increased risk for psychiatric problems. Regularpsychological evaluation and referral to child and adolescent psychiatry clinics may facilitate timely diagnosis andeffective treatment of at-risk children and adolescents.

Use of Pediatric Observation Units: Experience from a Tertiary Care Training Hospital inTurkey

ABS TRACT Objective: A pediatric observation unit may help to alleviate some of the stress caused by an increased number of patients. The aim of this study is to identify the intended functions as well as the clinical and operating characteristics of our observation unit, which is an alternative and important option to our inpatient and emergency services. Material and Methods: The hospital records of children aged between 0 months and 18 years who were admitted to our observation unit between January 2014 and December 2014 were reviewed. The patients’ demographic and clinical characteristics, diagnosis at admission, the number of patients admitted to wards, the percentage of patients referred to other hospitals, and the length of observation were analyzed. Results: A total of 115.729 patients admitted to the emergency department in a year. Of these patients, 121 (0.10%) were admitted to a ward appropriate for their age and disease, while 7007 (6.05%) were admitted to the observation unit. Of the patients monitored in the observation unit, 2110 (30.11%) were eventually admitted to clinics appropriate for their age. 1559 (26.85%) of patients admitted to the observation unit had gastrointestinal system diseases; 1270 (18.12%) had nervous system diseases; 1265 (18.05%) had respiratory system diseases; and 1137 (16.24%) had infectious diseases. We found that 5970 of 7007 (85.20%) patients admitted to the observation unit stayed less than 24 hours, and 1037 (14.79%) patients stayed more than 24 hours. The mean length of stay for all patients admitted to the observation unit was 13 hours, 28 minutes (1,40 ± 34,4). Conclusion: Our observation unit has an important role in assessing and managing children with a variety of diseases. Also; our observation unit functions as a holding unit to provide short term care of overflow inpatients.

Çocukta obezite ile birlikte lipoödematöz skalp

On bir yasindaki kiz cocugu basinin cesitli bolgelerinde sungerimsi yapida sislikler olmasi nedeniyle basvurdu. Bu bolgelerdeki sac gelisimi ve cilt normal gorunuyordu. Eksojen obezite disinda sistemik hastalik bulgusu yoktu. Ultrasonografi sislik bolgesinde cilt alti doku kalinliginda artis oldugunu gosterdi. Histopatolojik inceleme dermisde elastik liflerde kirilma ve cok sayida kil follikulu iceren cilt alti yag dokusunda kalinlik artisi oldugunu ortaya cikardi. Klinik ozellikler ve lezyondaki histopatolojik degisikler daha once cogunlukla yetiskin kadinlarda tanimlanan lipoodematoz skalp tanisi ile uyumlu idi.