Adverse effects of antiepileptic drugs on bone mineral density

The aim of this study is to determine the frequency of changes in biochemical markers of bone metabolism in children who are receiving valproic acid, carbamazepine, and oxcarbazepine. Thirty healthy children and 68 children with idiopathic epilepsy treated with either carbamazepine (n = 23), valproic acid (n = 31), or oxcarbazepine (n = 14) for more than 1 year were enrolled into the study. Blood samples were obtained in order to determine biochemical parameters (calcium, phosphorus, alkaline phosphates, parathormone, and 25-hydroxyvitamin D). Bone mineral density was measured with the dual-energy x-ray absorptiometry method. There were no significant differences in the serum concentrations of calcium, phosphorus, aspartate aminotransferase, alanine aminotransferase, and albumin levels between the four groups. However, serum alkaline phosphatase concentrations were higher in the patient group as compared with the control subjects. In patients receiving antiepileptic drugs, bone mineral density values were significantly lower than the healthy control group. In conclusion, long-term antiepileptic drug treatment either with valproic acid, carbamazepine, or with oxcarbazepine which has unknown effects on skeletal mineralization, induces a state of decreased bone mineral density. (c) 2006 by Elsevier Inc. All rights reserved

Contact Dermatitis With Henna Tattoo

Allergic and irritant reactions to henna are rare, Para-phenylenediamine, which is sometimes added to obtain a dark, blackish henna, causes the majority of contact dermatitis reported related with tattoos. Allergic contact dermatitis due to temporary paint-on tattoo with black henna is described in two adolescents

Subscapular Abscess After Blunt Trauma

Infection around the shoulder girdle is an infrequent and difficult diagnosis requiring a high index of suspicion and early evaluation by the physician. An infection within the area of the subscapularis Muscle and the chest wall is extremely rare. To the best of our knowledge, only 4 cases of subscapular abscess have been reported. In this article, we present a 7-year-old boy with a subscapular abscess after blunt trauma

The role of mean platelet volume predicting acute exacerbations of cystic fibrosis in children

Objective: The aim of this study is to evaluate the relationship between acute exacerbations and the mean platelet volume (MPV) trend in children with cystic fibrosis (CF), to predict the exacerbations. Methods: A total of 46 children with CF and 37 healthy children were enrolled in the study. White blood cell count (WBC), hemoglobin level, platelet count, mean platelet volume (MPV), and mean corpuscular volume (MCV) were retrospectively recorded. Results: Our study population consisted of 25 (54.3%) males and 21 (45.7%) females with CF and 20 (54.0%) males and 17 (46.0%) females in the healthy control group. The mean age of the CF patients was 6.32 ± 4.9 years and that of the healthy subjects was 7.02 ± 3.15 years. In the acute exacerbation period of CF, the MPV values were lower and WBC and platelet counts were higher than those in the healthy controls (P = 0.00, P = 0.00, P = 0.00, respectively). Besides, in acute exacerbation, the MPV values were lower and the WBC count was higher than the values in the non-exacerbation period (P 0= 0.01, P = 0.00, respectively). In the non-exacerbation period MPV was lower and platelet count was higher when compared to healthy subjects (P = 0.02, P = 0.04, respectively). Conclusion: This study suggests that MPV might be used as a simple, cost effective, diagnostic, predictive indicator for platelet activation in pediatric CF patients related to chronic inflammation, which might be helpful to discriminate or estimate exacerbations

A neglected problem of developing countries: Noncystic fibrosis bronchiectasis

Background:Bronchiectasis has been defined as the abnormal and permanent dilation of the bronchi. It is still an important problem in many developing countries. Aim:The aim of this study was to identify the chacteristics and underlying etiology of children followed with the diagnosis of noncystic fibrosis bronchiectasis. Materials and Methods:Children with bronchiectasis confirmed with high-resolution computed tomography were enrolled into the study. The data of the patients, including symptoms of the disease, age at the onset of symptoms, findings of physical examination, labrotory investigations performed in order to identify the etiology of bronchiectasis, etiology of bronchiectasis if found, radiologic findings and treatment modalities were noted. Results: Sixty-six children between 1 and 17 years were included in the study retrospectively. Forty-four of them were males (66.7) and 22 (33.3) were females. The most common presenting symptoms were cough (100) and sputum expectoration (50). An underlying etiology was identified in 44 (66.7) of the study subjects. The four most common underlying causes were found as infections (21.2), asthma (16.7), aspiration syndromes and/or gastroesophageal reflux disease (9.1) and immunodeficiency syndromes (7.6), respectively. Conclusion:Identifying an underlying etiology will have a significant effect on the management of noncystic fibrosis bronchiectasis. Defining the cause of bronchiectasis may also decrease its incidence, progression and complications

Relation between serum IL-4, IL-13 and IFN-gamma levels and recurrence of wheezing episodes in infants with acute bronchiolitis

Lower respiratory tract infections are the most important factors among various causes which trigger wheezing in the first year of life. The factors associated with episodic wheezing in children with acute bronchiolitis are still subjects of research. Infections, environmental factors, immunologic mechanisms are sorted as etiologic risk factors of episodic wheezing. We aimed to investigate the relationship between serum interleukin (IL)-4, IL-13 and gamma-interferon (IFN-gamma) levels and recurrence of wheezing episodes in infants with acute bronchiolitis. One hundred twenty infants between 3 and 36 months with acute bronchiolitis enrolled in the study. Personal histories, clinical and laboratory data of infants were recorded. The patients were followed for a year. Venous blood samples were obtained to determine serum IL-4, IL-13, and IFN-gamma levels during acute bronchiolitis episode. The number of wheezing episodes was significantly higher in infants with a positive family history of allergy. A statistically significant correlation was determined between serum IL-13 levels of infants and number of wheezing episodes. High serum IL-13 levels and a positive history of allergy may have important roles in the recurrence of acute bronchiolitis

The determination of asthma, rhinitis, eczema, and atopy prevalence in 9-to 11-year-old children in the city of Izmir

The International Study of Asthma and Allergies in Childhood (ISAAC) phase II was designed to allow comparisons between populations in different countries and to investigate possible etiologic factors. This study was conducted to better delineate the prevalence and etiologic factors of asthma, rhinitis, and eczema in Izmir (Turkey) and to be included in the international comparisons by using a standard methodology of ISAAC phase II. The questionnaire was distributed to 2112 students in the 3rd, 4th, and 5th grades of 12 selected primary schools in urban and rural boroughs of Izmir. One thousand two hundred seventeen of these questionnaires were evaluated and physical examinations and skin-prick tests were performed on 1098 of these children. The prevalence values were 15.9% for recent wheezing and 4.8% for physician-diagnosed asthma. The prevalence of sneezing or runny or blocked nose in the past 12 months when the child did not have a cold or flu was 30%. The prevalence of physician-diagnosed allergic rhinitis was 17%. The prevalence of an itchy rash that was coming and going for at least 6 months was 7.2% and the prevalence of physician-diagnosed eczema was 4.9%. Atopic sensitization prevalence in the population was 8.8% with house-dust mite sensitization being the most frequent one. Secretion rales and sibilant -wheezing rhoncus were detected in 2.7% of children by chest auscultation. In 1.1% of children flexural dermatitis was detected. Objective tests are necessary for epidemiologic studies of the aforementioned diseases

Histopathologic changes of the lung in newborn mice born from asthmatic mothers

Objective: Asthma has its origins in early-life. Maternal asthma is an important risk factor, the mechanism of this effect is still unknown. The aim of this study was to evaluate the histopathologic changes of the lung in newborn mice born from asthmatic mother. Material and Methods: 28 BALB/c mice were divided into 4 groups; Group I (Astmatic mother mice), Group II (Control mother mice), Group III (Babies from asthmatic mother) and Group TV (Babies from control group). Mice in group I were sensitized with ovalbumin and mice in group II received saline. Mothers and I-day-old baby mice were sacrified and airway histopathology was evaluated by using light and electron microscopy in all groups. Results: In asthmatic mother mice group (Group I), all histopathologic parameters including thickness of the epithelium, basement membrane and subepithelial smooth muscle were significantly higher when compared with the control group (Group II) (p = 0.000, p = 0.000, p = 0.000 respectively). When Group III and IV were compared with each other, the thickness of the epithelium, basement membrane and subepithelial smooth muscle were significantly higher in babies born from asthmatic mothers (p = 0.000, p = 0.000, p = 0.000 respectively). Conclusion: The results of this study suggest that structural changes of the lung may begin in the prenatal period in babies born from asthmatic mothers. Further studies are needed to clarify the histopathologic changes of the lung in childen of asthmatic mothers, which factors influence these changes and whether these changes are permanent or temporary