Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Comparison of multislice computed tomography angiography and digital subtraction angiography in the detection of residual or recurrent aneurysm after surgical clipping with titanium clips

To determine the diagnostic accuracy of 3D-CTA using volume rendering (VR) in the detection of residual or recurrent cerebral aneurysms after clipping

Sonographic diagnosis of choledochocele

We present a case of a 48-year-old female with a history of cholecystectomy and recurrent attacks of pancreatitis whose initial abdominal sonography (US) revealed multiple conglomerated stones in the descending part of the duodenum. Abdominal CT, MRI, and magnetic resonance cholangiopancreatography showed the same findings. The distended sacciform distal intramural segment of the common bile duct was protruding into the duodenum. The imaging findings explained the etiology of the patient's recurrent attacks of pancreatitis and led to surgical excision of the choledococele. (c) 2011 Wiley Periodicals, Inc. J Clin Ultrasound 40:448450, 201

Sonographic Diagnosis of Penile Mondor's Disease Associated with Absence of a Dorsal Penile Artery

Penile Mondor's disease is an unusual condition, which is characterized by thrombosis in superficial dorsal penile vein. Here, we report the sonographic findings of this disease in a 35-year-old male along with the absence of right dorsal penile artery. (C) 2009 Wiley Periodicals, Inc. J Clin Ultrasound 38:263-266, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.2065

Duodenal Duplication Cyst: A Rare Cause of Acute Pancreatitis in Children

Duodenal duplication is a rare cause of acute pancreatitis in children. We report a case of acute pancreatitis in which abdominal sonography revealed an enlarged hypoechoic edematous pancreas with mildly dilated main pancreatic duct and a cystic structure with layered wall in the second part of duodenum. Abdominal CT yielded similar findings. The diagnosis of duodenal duplication was confirmed at surgery and subsequent histopathologic examination. (C) 2008 Wiley Periodicals, Inc. J Clin Ultrasound 36:584-586, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.2047

FGF-23 associated with the progression of coronary artery calcification in hemodialysis patients

Background: Disordered mineral metabolism is implicated in the pathogenesis of vascular calcification in hemodialysis (HD) patients. Fibroblast growth factor 23 (FGF-23) is the main regulator of phosphate metabolism. In this prospective study, we aimed to investigate the association of serum FGF-23 with progression of coronary artery calcification in HD patients

Efficiency of Magnetic Resonance Imaging in Regional Diagnosis and Classification of Advanced Chondropathies of Knee Joint

Objective: Today, magnetic resonance imaging (MRI) procedures used to detect and measure articular hyaline cartilaginous defects are being increasingly investigated. In this study, we evaluated the sensitivity and diagnostic efficiency of MRI in the detection of particularly advanced cartilage pathologies compared to the arthroscopic results

Diffusion tensor imaging of cysts, hemangiomas, and metastases of the liver

Background: Although diffusion-weighted magnetic resonance imaging imaging (DW-MRI) is commonly used to characterize hepatic lesions, the literature is sparse about the use of MR diffusion tensor imaging (DTI) in this regard. By using DTI, one is able to obtain not only apparent diffusion coefficients (ADCs) but also fractional anisotropy (Fa) values

Sonographic Appearance of the Normal Appendix in Children

Purpose. To determine the visualization rate of the appendix in children without appendicitis and investigate factors affecting it