Invasive Fungal Infections in Children with Acute Lymphoblastic Leukemia: Experience from a Reference University Hospital in Cappadocia

Invasive fungal infections (IFI) are an important cause of mortality and morbidity in patients with hematological malignancy. This study aims to investigate the incidence of IFI development, risk factors, the management of the infection in a pediatric patient group followed up with the diagnosis of acute lymphoblastic leukemia (ALL), and to share the experience obtained from a single center. Two hundred forty children monitored with the diagnosis of ALL in the pediatric hematology-oncology department of the Erciyes University Medical Faculty from January 2010 to September 2017 included in the study. A total of 30 (14 females and 14 males) IR attacks were diagnosed (12.5%) in the included patients with ALL, two of them having the attacks twice. Candida species were the dominant cause of infection (n= 17) and the rest (n= 8) had invasive Aspergillosis. Nineteen IFI attacks were assessed as proven, 6 as probable, and 5 as possible IFI. The most fungal infection was detected in blood culture (43.3%) followed by pulmonary involvement (40%). The most frequently used diagnostic methods were direct microscopic examination, histological examination, and cultures (66.6%). IFI-related mortality was 20%. IFI continues to be an important problem in pediatric patients with hematologic malignity. The 7 of the observed invasive Aspergillosis developed in non hepafiltered room. Treatment of neutropenic children in hepafiltered rooms decrease the risk of IFI. With careful assessment of the patients bearing risk factors for IFI development, early diagnosis and treatment will reduce morbidity and mortality

Brain Abscesses in Children: Results of 24 Children From a Reference Center in Central Anatolia, Turkey

Childhood brain abscesses are a rare and potentially life-threatening condition requiring urgent diagnosis and treatment. This retrospective study analyzed the clinical and radiologic findings of 24 (7 girl, 17 boys) cases with brain abscess. Mean age was 92.98 +/- 68.04 months. The most common presenting symptoms were nausea-vomiting (45.8%) and headache (41.7%). Brain abscess was most commonly located in the frontal region. Diffusion restriction was determined in 78.4% of lesions. The mean apparent diffusion coefficient value in these lesions was 0.511 +/- 0.23 x 10(-3) mm(2)/s. Cultures were sterile in 40% of cases. Antimicrobial therapy was given to only 16.7% of cases. Predisposing factors were identified in 91.6% of cases (congenital heart disease in 20.8% and immunosuppression in 20.8%). Mortality level was 12.5%. In conclusion, immunocompromised states, and congenital heart disease have become an important predisposing factor for brain abscesses. Effective and prompt management should ensure better outcome in childhood

LigaSure compared with ligatures and endoclips in experimental appendectomy:How safe is it?

The present study aims to compare strength, healing, and inflammation of appendiceal stumps closed by LigaSure Precise (TM) (Valleylab, Boulder, CO, USA) device, ligatures using polyglactin 910 (Vicryl, Ethicon, Edinburgh, UK) and endoclips (Ligaclip ERCA, Ethicon, OH, USA), and operation time (OT) in experimental appendectomy