Çocukluk Çağında Romatizmal Hastalıkların Romatizma Dışı Ayırıcı Tanıları

ÖZET Romatolojik hastalıklarda klinik spektrum oldukça geniştir. Ateş, halsizlik, eklem ağrıları ve cilt lezyonları romatolojik hastalıklarda sık görülen semptomlardır. Baş ağrısı, nöropati, kas güçsüzlüğü, nöbetler ve bilişsel bozukluklar gibi nörolojik semptomlar romatolojik hastalıkların seyrinde ortaya çı- kabileceği gibi ilk başvuru sebebi de olabilir. Yeni çalışmalarla nörolojik pek çok hastalığın altında yatan otoimmün mekanizmalar araştırılmakta ve romatolojik hastalıklarla benzer patofizyolojik mekanizma- lar aydınlatılmaktadır. Başta sistemik lupus eritematozus, Sjögren ve Behçet olmak üzere pek çok ro- matolojik hastalıkta santral sinir sistemi ve periferik sinir sistemi tutulumları sıklıkla görülmektedir. Nörolojik bulgularla başvuran hastada ayırıcı tanıda romatolojik hastalıkların değerlendirilmesi tanının gecikmemesi açısından önemlidir. Bu sayede oluşabilecek kalıcı nörolojik sekeller önlenebileceği gibi morbidite ve mortalite sıklığı azaltılabilir. Anahtar Kelimeler: Sinir sistemi hastalıkları; nörolojik belirtile

Human biomonitoring of trace elements (Zn, Cu, Mn, Cd and As) level in a healthy urban population in Türkiye

Human biomonitoring (HBM) studies are carried out to examine the effects of environmental pollutants on human health and to identify risks to public health, with the increasing awareness of environmental pollution around the world. The aim of our study is to determine the level of trace elements and to perform preliminary human biomonitoring of a healthy urban population in Türkiye. For this purpose, healthy individuals living in the same region and not known to have occupational or any other exposures were included in the study. Element levels from serum/blood of volunteers were determined. In this study, Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was used to analyze in order to determine the multi elements in a more precise way with an improved analytical quality of results. According to our study’s results, Mn and As (p<0.05) were found statistically significant with age. Smoking had an effect on Cd levels (p<0.01) and there were significant differences between males and females for only Zn (p[removed

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought