PNEUMOTHORAX IN NEWBORN: OUR EXPERIENCE

Amaç: Yenidoğan döneminde solunum sıkıntısı yapan nedenlerden biri de pnömotoraks olup, mekanik ventilasyon tedavisi, mekonyum aspirasyonu sendromu, solunum güçlüğü sendromu ve perinatal asfiksi nedeniyle canlandırma işlemi uygulanan olgularda gelişme riski yüksektir. Hastanemiz yenidoğan bakım ünitesinde semptomatik pnömotoraks saptanarak tedavi edilen olgular geriye dönük olarak incelenmiştir. Gereç ve yöntem: Ocak 2003-Ocak 2006 tarihleri arasındaki 7 pnömotorakslı olguda gestasyonel yaş, ağırlık, aminon sıvısının mekonyumla boyalı olup olmadığı, primer akciğer patolojisi varlığı ve pnömotoraksın tarafı değerlendirildi. Tanıda akciğer grafisi ve bazı olgularda konjenital anomali varlığını araştırmak için bilgisayarlı tomografi yapıldı. Toraks drenaj işlemi için 10 F tüp kullanıldı. Bulgular: 7 olgunun değerlendirilmesinde; pnömotoraks insidansı %1,2 (7/570), erkek kız oranı 1,3, başvuru zamanı 10 saat ile 6 gün idi. 5 hasta (%71,4) prematürdü. Pnömotoraks sağda 3 (%42,9), bilateral 4 (%57,1) vakada mevcuttu. Serimizde mortalite % 57,1 olarak bulunmuştur. Vefat eden olguların büyük bir kısmı (%75) prematüre, solunum güçlüğü sendromlu ve iki taraflı pnömotoraksı olan olgulardı. Sonuç: Yenidoğan pnömotoraks olgularında mortalitenin prematürite, SGS ve iki taraflı pnömotoraks varlığında yüksek olması literatür ile uyumlu bulundu. Objective: Pneumothorax is one of the important etiologic factors in newborn which causes respiratory distress. Pneumothorax usually occurs in newborns under mechanical ventilation. Respiratory distress syndrome, meconium aspiration syndrome and resuscitation after birth may also cause pneumothorax. We retrospectively reviewed patients who were hospitalized for pneumothorax in our newborn intensive care unit. Material and method: Between January 2003 and January 2006, 7 cases were treated for pneumothorax. These cases were analyzed according to gestational age, existence of meconium in the amniotic fluid, primary lung pathology, weight, and side of pneumothorax. The relation between these criteria and the mortality was investigated. 10 F tube were used for thoracostomy. The diagnosis was made by chest x-rays, computerized tomography was used to examine presence of congenital anomalies. Results: The incidence of pneumothorax in the neonates treated in our intensive care unit is found to be 1,2 % (7/570). M:F ratio was 1.3. Age of admittance ranged from 10 hours to 6 days. Five patients (71,4) were premature. Pneumothorax was present at right hemithorax in 3 (42,9%) while 4 patients (%57,1) were bilaterally affected. Mortality rate was 57,1%. Most of the patients who died were premature (75%) and had bilateral pneumothorax. Conclusion: Also seen in the literature, we found that the mortality rate was higher in premature, RDS patients and the patients who had bilateral pneumothorax

Pseudo Bartter syndrome: A case report

İki gündür akciğer enfeksiyonu yakınmaları olan 7.5 aylık kız hasta, konvülsiyon nedeniyle acil polikliniğimize getirildi. Yoğun bakım ünitesindeki izlemi sırasında hiponatremi, hipokalemi, hipokloremi ve metabolik alkalozu saptanan hastaya psödo Bartter sendromu tanısı konuldu. İntravenöz sıvı ve uygun defisit tedavileriyle genel durumu, elektrolit bozukluğu ve alkalozu düzeldi. Ter testi sonucu 120 mEq/L bulunan hasta bir kistik fibrozis hastası olarak izleme alındı.A 7.5-month-old girl was brought to our emergency department with the complaint of pulmonary infection for 2 days. Pseudo Bartter syndrome was diagnosed in this patient with hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis during follow-up in the intensive care unit. The patient’s general condition, electrolyte imbalance and alkalosis improved with intravenous fluid treatment and appropriate deficit therapy. The patient was followed subsequently with cystic fibrosis based on sweat test result of 120 mEq/L

Vitamin D-resistant rickets, primary hypothyroidism, and diabetes insipidus associated with infantile cystinosis

WOS: 000239630600445

CONGENITAL IMPERFORATE HYMEN WITH BILATERAL HYDRONEPHROSIS, POLYDACTYLY AND LARYNGOCELE: A Rare Neonatal Presentation

WOS: 000275954100004PubMed: 20334483Imperforate hymen is a rare congenital malformation to present with symptoms in the neonatal period. We present a case of a 5-day-old neonate with a marked interlabial swelling causing urinary retention. Imaging revealed hydrometrocolpos, hydrosalpinx, and bilateral hydronephrosis. Additionally, our patient had polydactyly of both feet and hands, and laryngocele that have not been previously described in literature. Hymenectomy is the mainstay of management to prevent the development of hematocolpos, pain, and possible retrograde menstruation.</

The prevalence of overweight and obese children aged 6-17 years in the West Black Sea region of Turkey

WOS: 000256492900014PubMed: 18021206Objective: To assess the prevalence of overweight and obese Turkish children. Design: Cross-sectional study in school children. Subjects: A total of 6924 children (3281 boys and 3643 girls) aged 6-17 years from the West Black Sea region of Turkey. Measurements: Overweight and obese were defined using international age- and sex-specific cutoff points for body mass index. The data were analysed by age, sex, residence and socioeconomic level. Results: The overall prevalence of overweight and obesity was 10.3% and 6.1% respectively. The overall prevalence of obesity in boys and girls was 7.0% and 5.4%, respectively, and the difference was significant (chi(2) = 8, p = 0.004). The prevalence of obesity in urban and rural areas was 7.7% and 3.9%, respectively, and the difference was significant (chi(2) = 40, p 0.05). However, the prevalence of overweight boys and girls in rural areas was 4.8% and 9.4%, respectively, and the difference was significant (chi(2) = 25, p 0.5). The prevalence of obesity was significantly higher in private schools than in public schools (chi(2) = 48, p < 0.0001). The prevalence of overweight and obese Turkish children aged 6-17 years is considerably lower than in most European countries. The children in urban settings and higher socioeconomic groups had a higher prevalence of overweight and obesity. The Westernisation of the behaviour patterns of children and living in an urban setting in a developing country are risk factors for obesity

Lateral facial cleft associated with accessory mandible having teeth, absent parotid gland and peripheral facial weakness

WOS: 000346973000028PubMed: 24269646Transverse facial cleft is a very rare malformation. The Tessier no. 7 cleft is a lateral facial cleft which emanates from oral cavity and extends towards the tragus, involving both soft tissue and skeletal components. Here, we present a case having transverse facial cleft, accessory mandible having teeth, absent parotid gland and ipsilateral peripheral facial nerve weakness. After surgical repair of the cleft in 2-month of age, improvement of the facial nerve function was detected in 3-year of age. Resection of the accessory mandible was planned in 5-6 years of age. (C) 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved

Retrospective analysis of childhood poisoning cases in the west black sea region

Zehirlenmeye yol açan etkenler yaşanılan bölgeye, toplumun gelenek ve göreneklerine, ailenin eğitim düzeyine ve mevsimlere göre değişkenlik gösterebilir. Bu çalışmanın amacı, hastanemizde son iki yıl içinde yatırılarak tedavi edilen zehirlenme vakalarını gözden geçirmektir. Yöntem: Ocak 2003-aralık 2005 tarihleri arasında hastanemizde entoksikasyon tanısı alan yüz on dört hasta retrospektif olarak değerlendirildi. Bulgular: Zehirlenmeler en çok 1-5 yaş grubunda (% 78.9) gözlendi. Erkek/kız oranı 1.23’tü. Zehirlenmelerin en fazla sonbahar mevsiminde (% 28.1) olduğu görüldü. Zehirlenmeye neden olan etkenler sıklıkla ilaçlardı (% 50.9). En sık antipsikotikler ve analjezik-antipretik ilaçların alımı söz konusuydu. Sonuç: Zehirlenmelerin tedavisinde önemli gelişmeler olmakla birlikte, bu sorunun çözümünde en etkin yöntem koruyucu önlemlerin alınmasıdır.Toxins which cause intoxication in childhood vary according to settlement areas, traditions in the society, parental education and seasons. The aim of the study was to evaluate children who were hospitalized for intoxication in the last 2 years in our hospital. Method: A total of 114 patients diagnosed as intoxication between January 2003 and December 2005 were reviewed retrospectively. Results: The majority of the cases were 1-5 years of age (78.9 %). The male/female ratio was 1.23. Poisoning incidence was highest during the autumn (28.1 %). Main cause of intoxication was drugs (50.9 %). The most frequent drugs administered were antipsychotics-antidepressants and analgesics-antipyretics. Conclusion: Despite important improvements in the management of intoxication prevention of poisoning is stil the most effective method

Neonatal Graves' disease occurring in an infant whose mother had a thyroidectomy due to Graves' disease [Graves hastali?i nedeniyle tiroidektomi olan annenin yenido?an bebe?inde Graves hastali?i: Bir vaka takdimi]

Neonatal Graves' disease caused by fetal thyroid gland stimulation is the result of transplacental passage of maternal thyroid-stimulating hormone receptor antibodies in the second trimester of pregnancy. A mother with Graves-Basedow disease had a total thyroidectomy operation three months before a pregnancy; maternal TSH receptor antibody (TRAb) were detected at the sixth month of pregnancy. Antithyroid drug therapy was started to the 34 weeks' gestational age infant, who was diagnosed with neonatal hyperthyroidism. The condition improved after five weeks of antithyroid therapy. The pathogenesis was believed to be due to transplacental passage of maternal TRAb. This case is presented to highlight the fact that even mothers who have a total throidectomy for Graves' disease may have infants with rarely seen neonatal Graves' disease due to the presence of maternal TRAb in the circulation

A case of tuberous sclerosis presenting with suprevantricular tachycardia in a 3 month old infant

Tuberoskleroz birçok organda hamartomlara neden olan otozomal dominant kalıtımla geçen bir bozukluktur. Çocukluk çağının en sık görülen kalp tümörü olan rabdomyomların tuberoskleroz ile olan ilişkisi iyi bilinmektedir. Kardiyak rabdomyomlara bağlı aritmiler tuberosklerozun başlangıç bulgusu olabilir. Biz burada, ekokardiyografi incelemesinde çok sayıda kardiyak rabdomyom bulunan, supraventriküler taşikardi ile kendini gösteren 3 aylık bir kız olgusunu sunuyoruz.Tuberous sclerosis complex is an autosomal dominant disorder in which hamartomas occur in several organs. Cardiac rhabdomyomas, the most common heart tumors of childhood, are well known to be associated with tuberous sclerosis complex. Arrhythmia due to cardiac rhabdomyomas may be the initial sign of tuberous sclerosis. We present here a case of tuberous sclerosis presenting with supraventricular tachycardia in 3 month-old girl who was found to have multiple cardiac rhabdomyomas during echocardiographic examination

A child with bradycardia and hypotension related to mad honey intoxication

Deli bal zehirlenmesi Türkiyenin Karadeniz Bölgesinde görülen bir durumdur. Bu zehirlenmenin nedeni, bölgedeki dağlarda doğal olarak yetişen Rhododendron ponticum bitki türünün nektarından elde edilen balda bulunan, grayanotoksin diye bilinen toksinden kaynaklanır. Burada, bal yedikten sonra kan basıncı düşüklüğü ve bradikardi nedeniyle gelişen halsizlik ve baş dönmesi yakınmaları ile acil servise getirilen 15 yaşındaki bir erkek çocuk sunuldu. (Türk Ped Arfl 2013; 48: 53-4)Mad honey poisoning is a well known condition in the Black Sea Region of Turkey. The cause of the poisoning is the toxin known as grayanotoxin found in honey obtained from the nectar of Rhododendron ponticum species growing naturally on the mountains in the region. Here in we presented a 15-year-old boy was brought to the emergency department with weakness and dizziness due to bradycardia and hypotension after eating mad honey