Which Criteria are More Valuable in Defining Hemodynamic Significance of Patent Ductus Arteriosus in Premature Infants? Respiratory or Echocardiographic?

Aim: Patent ductus arteriosus (PDA) is a frequent health problem in premature infants. Pharmacologic closure is recommended only for hemodynamically significant PDA (hsPDA) that is defined according to the clinical and echocardiographic criteria. The aim of this study was to explore the value of commonly used criteria in defining hsPDA and predicting the required number of courses of ibuprofen treatment to close PDA in premature infants. Methods: Sixty premature infants with a gestational age of ≤33 weeks were evaluated prospectively. Clinical and echocardiographic criteria [O2 requirement, ductus diameter (DD) and left atrial-to-aortic root diameter ratio (LA:Ao)] were used to define hsPDA. Clinical improvement after pharmacologic closure of PDA and association between the criteria and required number of ibuprofen courses were investigated. Results: O2 requirement decreased by PDA closure but was not different between patients with hsPDA and the others with PDA. Also, O2 requirement was not found to be associated with required number of ibuprofen courses. DD and LA:Ao were greater in patients with hsPDA. DD was found to be associated with required number of courses of ibuprofen treatment. Conclusion: Although there was an improvement in O2 requirement with PDA closure, echocardiographic criteria were found to be more valuable in defining hsPDA. DD should also be used to estimate the duration of treatment

An Outbreak of Oropharyngeal Tularemia with Cervical Adenopathy Predominantly in the Left Side

Karabay, Oguz/0000-0003-0502-432XWOS: 000263836900007PubMed: 19259348Purpose: We describe the epidemiological and clinical characteristics and the efficacy of a delayed initiation to therapy in an oropharyngeal tularemia outbreak in Duzce, Turkey. Materials and Methods: Between March and June 2000, 22 patients with tularemia were diagnosed by microagglutination tests. Results: Oropharyngeal and ulceroglandular forms of the disease were discovered. Most of the cases were oropharyngeal (19 cases). The most common symptoms were sore throat (95.4%) and fever (90.9%). Lymphadenopathy (95.4%) and pharyngeal hyperemia (81.8%) were usually observed signs. The lymphadenopathies were localized especially in the left cervical region (66.7%), a finding that has not been previously reported in the literature. The time between the onset of the symptoms and diagnosis was 40.7 +/- 22.8 (10-90) days. The patients were treated with streptomycin plus doxycycline and ciprofloxacin. The patients' recoveries took up to 120 days. Conclusion: This report describes the first outbreak of tularemia in northwest Turkey. Tularemia may occur in any region where appropriate epidemiological conditions are found and should be kept ill mind for differential diagnosis in oropharyngeal symptoms. Late initiation of therapy may delay complete recovery. In this outbreak, cervical lymph nodes predominantly localized on the left side were found, which had not been previously reported

Clinical scoring for distinction of bacterial and viral upper respiratory tract infections of children

Introduction: Upper respiratory tract infections (URTI) are the most common infections of childhood.  The purpose of our study is to develop a clinical scoring method to distinguish viral and bacterial infections in the patients who were diagnosed with URTI. Methods: This study was conducted in pediatric 220 patients with URTI whose ages were between 5 and 15. The previous studies about clinical scoring of bacterial and nonbacterial URTI were reviewed to determine signs and symptoms to evaluate in our study. These signs, symptoms and throat swab culture results of the patients were recorded. Results: Throat swab culture were positive at 93 patients (42%). According to this clinic scoring system; fever, painful anterior servical lymphadenopathy, lack of cough, tonsillar hypertrophy were found to be statistically significant in terms of predicting bacterial infections. Dysphagia, abdominal pain, headache, lack of conjunctivitis, the absence of hoarseness and the absence of diarrhea were found to be statistically insignificant. Conclusion: Acording to total score – culture relationship, total score 7 and higher could be considered significant. As a result of our study, we could not develop an effective scoring due to the high number of parameters, low sensitivity and specifity

Clinical scoring for distinction of bacterial and viral upper respiratory tract infections of children

Introduction: Upper respiratory tract infections (URTI) are the most common infections of childhood.  The purpose of our study is to develop a clinical scoring method to distinguish viral and bacterial infections in the patients who were diagnosed with URTI. Methods: This study was conducted in pediatric 220 patients with URTI whose ages were between 5 and 15. The previous studies about clinical scoring of bacterial and nonbacterial URTI were reviewed to determine signs and symptoms to evaluate in our study. These signs, symptoms and throat swab culture results of the patients were recorded. Results: Throat swab culture were positive at 93 patients (42%). According to this clinic scoring system; fever, painful anterior servical lymphadenopathy, lack of cough, tonsillar hypertrophy were found to be statistically significant in terms of predicting bacterial infections. Dysphagia, abdominal pain, headache, lack of conjunctivitis, the absence of hoarseness and the absence of diarrhea were found to be statistically insignificant. Conclusion: Acording to total score – culture relationship, total score 7 and higher could be considered significant. As a result of our study, we could not develop an effective scoring due to the high number of parameters, low sensitivity and specifity

Prevalance and risk factors for yeast colonization in adult diabetic patients

Karabay, Oguz/0000-0003-0502-432XWOS: 000233929200007PubMed: 16370540