Vedat Okutan

Evaluation of bone mineral density in children receiving antiepileptic drugs

The effects of the valproic acid and carbamazepine monotherapies on bone mineral density were evaluated. Bone mineral density was measured in 53 children with primary epilepsy taking either valproic acid (n = 25) or carbamazepine (n = 28) for longer than 1 year and in a healthy control group (n = 26) by the dual-energy x-ray absorptiometry method at L2-L4 levels of lumbar vertebrae. The mean serum levels of valproic acid and carbamazepine were 66 +/- 2.2 microg/mL and 7.0 +/- 9.3 microg/mL, respectively, and the mean duration of treatment for each drug was 2.4 +/- 0.2 years and 2.6 +/- 0.5 years, respectively. Calcium intakes in diet were similar in both the control and study groups. The serum levels of calcium and phosphorus in all groups were normal. Bone mineral density values of both valproic acid and carbamazepine groups were not statistically different from that of the control group (P > 0.05).

The effect of iron supplementation on visual-evoked potentials in infants with iron-deficiency anemia.

Flash visual-evoked potentials were studied in 20 infants with iron-deficiency anemia to determine the effect of iron deficiency on visual function by using visual-evoked potentials in this type of anemia. After iron therapy for 12 weeks, visual-evoked potentials were retested in these otherwise healthy infants. All infants showed an excellent hematological response to iron therapy. Post-treatment visual-evoked potential N2 latencies (negative deflections) decreased significantly compared to the pre-treatment values (p < 0.05). These results suggest that iron-deficiency anemia causes subclinical visual impairment, and visual-evoked potentials may be a useful non-invasive means of detecting subtle effects of nutritional deficiencies and monitoring the nutritional status of infants.

The role of erythrocyte protoporphyrin in the diagnosis of iron deficiency anemia of children.

The values of erythrocyte protoporphyrin, ferritin and mean corpuscular volume (MCV) measurements in diagnosing iron deficiency anemia were investigated in 72 iron deficient and in 25 healthy control infants. Receiver operator curve, sensitivity and specificity of erythrocyte protoporphyrin, ferritin and mean corpuscular volume were compared between the study and control groups. In the study group mean corpuscular volume, hemoglobin and ferritin concentrations were significantly lower, and erythrocyte protoporphyrin was significantly higher when compared to the control group. In the iron deficient study group, erythrocyte protoporphyrin was the most sensitive test and ferritin was the most specific test, whereas ferritin was the most diagnostic test and mean corpuscular volume was the least diagnostic test. A significant correlation between erythrocyte protoporphyrin and hemoglobin values was determined. We conclude that erythrocyte protoporphyrin is a more sensitive but less specific test than ferritin, and it can be used as a first-line diagnostic test in the evaluation of iron deficiency and in diagnosing iron deficiency anemia in infants.

Efficacy and safety of rectal thiopental sedation in outpatient echocardiographic examination of children.

The efficacy and safety of rectal thiopental administration in sedation for paediatric echocardiographic examination were prospectively investigated in infants with known or suspected congenital heart disease in an outpatient manner. A total of 1150 patients (546F, 604M) were studied; 264 were 7 d to 6 mo old (group I), 572 were 6 mo to 2‐y‐old (group II), and 314 were 2 to 6‐y‐old (group III). Thiopental sodium dissolved in 10 ml of water in a syringe to which a 6‐F feeding catheter was attached was administered prior to echocardiographic examination to patients in groups I, II and III with doses of 50, 35 and 25 mg/kg, respectively in an emergency care environment. Length of time to achieve sedation (induction time), duration of sedation, length of time to return to normal activity (recovery time), whether sedation was successful and side effects were recorded. In the overall study population, sedation was successful in 1094 (95.1%) of the patients, the induction time was 16.34 ± 3.69 min, the duration of sedation was 35.07 ± 7.04 min, the recovery time was 63.25 ± 10.17 min and the overall side‐effect prevalence was 2%. Sedation was significantly more successful, the induction time was significantly shorter, the recovery time was significantly longer and side effects significantly more prominent in groups I and II compared to group III.

Is a Standard Protocol Necessary for Oscillometric Blood Pressure Measurement in Term Newborns

Objective: The necessity of taking only one randomized blood pressure measurement or averaging three repeated measurements and, the effects of various stages of the restful state and body position on blood pressure measurements obtained with the oscillometric technique were investigated in 138 healthy term newborns. Methods: The Athena oscillometer was used to measure blood pressure. Three successive measurements with a 5-min interval were made in each of two positions, prone and supine, in random order 30 min after the last feeding if newborns were in very quiet or quiet sleep. During routine recording of vital signs, another (single) measurement was obtained before feeding the infant regardless of the body position of the newborn, provided that they were not struggling, crying or moving. Results: For all systolic, diastolic and mean blood pressures measured, there were no significant differences among either prone, supine and single measurements or among three successive measurements in each position. Conclusions: We conclude that, in the routine care of term newborns, blood pressure measurements with the oscillometric technique may be made without the need of a special position or sleep state, provided that the measurements are made with an appropriate sized cuff in the absence of struggling, crying and movement of the newborn. Taking only one randomized measurement under these conditions would be enough and practical in daily newborn care practice instead of repeating and averaging many measurements.

Benign Recurrent Abducens (Sixth) Nerve Palsy

Benign recurrent abducens nerve palsy is rare. Twenty-three cases in children have been reported in the literature and many of these cases followed immunization or were associated with viral illness. Most of the reported patients share the following features: spontaneous recovery within 6 months, ipsilateral recurrence, and painless palsy. The authors describe a Turkish child with recurrent abducens nerve palsy with no obvious etiology.

Auditory brainstem responses in children with congenital heart disease.

Abstract Background: Cyanotic congenital heart diseases usually lead to growth and developmental delay in children due to chronic hypoxemia and undernourishment that may affect the central nervous system. The auditory brainstem responses are determined to assess the maturation and function of the brainstem. Therefore, we used the auditory brainstem responses to investigate the effect of cyanotic congenital heart diseases on brainstem maturation.

Anticardiolipin Antibodies in Children with Helicobacter pylori Infection.

Anticardiolipin (aCL) antibodies are associated with thrombosis and have an important role in the etiology of diseases such as stroke and myocardial infarction whose etiologies were based on thrombosis. H. pylori has been proposed to be responsible for the pathophysiology of some diseases including stroke, myocardial infarction, thrombosis, and autoimmune diseases. From this point of view, we hypothesized a possible relationship between H. pylori infection and aCL antibodies and initially aimed to determine the prevalence of aCL antibody positivity in children with H. pylori infection.