Henoch-Schönlein purpura in children: A cross sectional study

Background: Henoch-Schönlein purpura (HSP) is a leukocytoclastic vasculitis with small vessel involvement and mainly affects the skin as well as joints, the gastrointestinal system (GIS), kidneys, and, more rarely, other organs. Objective: The objective of this study was to evaluate the sociodemographic characteristics, and clinical and laboratory findings of patients diagnosed with HSP. Materials and Methods: This was a retrospective study done to find out the sociodemographic data, clinical, laboratory findings, and treatment information of patients diagnosed with HSP and was admitted to the Pediatric Clinic of a tertiary care hospital between January 1, 2008, and August 31, 2013. The data were obtained from the hospital’s data processing system. HSP cases were validated according to EULAR/PRINTO/PRES criteria. Mean standard deviation, median, lowest and highest, frequency, and ratio values were used in the descriptive statistics of the data. Results: The study included 85 patients between the ages of 2 and 16 years, wherein 49 patients (57.6%) were male and 36 (42.4%) were female. The mean age was 9.9±3.3 years and 53 patients (62.4%) were under 10 years of age. The most common precipitating factor was upper respiratory tract infections. Purpura was the only symptom observed in all the patients and joint involvement was the second most common symptom (60%). GIS involvement was observed in 46 patients (58.8%) and intussusception was observed in one patient. Nine patients (10.6%) had renal involvement with mild nephropathy. The most frequently observed laboratory findings were increased C-reactive protein (47%) and leukocytosis (31%). Conclusion: HSP is commonly seen in children and leads to life-threatening complications in a minority of patients. Whole patients with GIS and renal involvement should be examined and monitored to assess the severity of the disease and any complications

Genome-wide association study identifies variants in the MHC class I, IL10, and IL23R-IL12RB2 regions associated with Behcet's disease

Behcet's disease is a genetically complex disease of unknown etiology characterized by recurrent inflammatory attacks affecting the orogenital mucosa, eyes and skin. We performed a genome-wide association study with 311,459 SNPs in 1,215 individuals with Behcet's disease (cases) and 1,278 healthy controls from Turkey. We confirmed the known association of Behcet's disease with HLA-B*51 and identified a second, independent association within the MHC Class I region. We also identified an association at IL10 (rs1518111, P = 1.88 x 10(-8)). Using a meta-analysis with an additional five cohorts from Turkey, the Middle East, Europe and Asia, comprising a total of 2,430 cases and 2,660 controls, we identified associations at IL10 (rs1518111, P = 3.54 x 10(-18), odds ratio = 1.45, 95% CI 1.34-1.58) and the IL23R-IL12RB2 locus (rs924080, P = 6.69 x 10(-9), OR = 1.28, 95% CI 1.18-1.39). The disease-associated IL10 variant (the rs1518111 A allele) was associated with diminished mRNA expression and low protein production

The Social and Health Problems of People Living with HIV/AIDS in Izmir, Turkey

Objective: The aim of this study was to describe how AIDS, as well as the stigma associated with it, affects the lives of HIV positive patients and their family members

The Social and Health Problems of People Living with HIV/AIDS in Izmir, Turkey

Objective: The aim of this study was to describe how AIDS, as well as the stigma associated with it, affects the lives of HIV positive patients and their family members. Materials and Methods: Three large state hospitals in the metropolitan area of Izmir participated in the study. Six focus groups were conducted with people infected with HIV (n=32) and their family members (n=11). Participants were asked to fill out a questionnaire to assess their HIV/AIDS knowledge and to convey how the stigma had affected them. Results: The most important problems identified were society and work-related social problems and access to health services. The patients and their family members stated that education was needed to correct misconceptions about HIV and to help them cope with related problems. We found that patients and their family members were sensitive about disclosure.Conclusion: We determined the education, counseling and support needs of HIV-infected patients and their families. Additionally, we found that health personnel who monitor the patients should make more efforts on patients’ education and counselling

Improving Knowledge and Attitudes of Health Care Providers Following Training on HIV/AIDS Related Issues: A Study in an Urban Turkish Area

WOS: 000302272100014Objective: The objective of the study was to assess HIV/AIDS related knowledge, attitudes and risk perception among health care providers in Izmir. Material and Methods: A pretest and posttest patterned intervention study was conducted in 2007 among health care providers participating in a training course on HIV/AIDS and universal precautions. The participants consisted of 158 health care professionals from 7 public hospitals and 2 public dental clinics. Information was collected regarding demographic details, HIV/AIDS related knowledge, attitudes and perceptions about patients at the beginning and the end of the course. Pre- and post-training dichotomous point scale scores were compared. Results: Of the participants, 72.6 % were females. Only 30.0 % of the respondents reported a scalpel or needle stick injury at least once last year. Some of the participants (40%) thought that it was necessary to take extra infection control precautions for patients with HIV. The average pre- and post-training mean knowledge scores were 9.32 +/- 2.1 (3-13) and 12.76 +/- 2.3 (5-17), respectively. The mean pre- and post-training beliefs scores were 12.37 +/- 3.1 (3-19) and 15.57 +/- 3.8 (6-22), respectively. There were significant differences in the pre- and post-training mean scores of the responses related to attitudes toward patients with AIDS. Conclusion: There was improvement in knowledge and negative attitudes on patients with AIDS at the end of the training. The results of this study suggested that the negative attitudes of health care providers towards individuals with AIDS due to the fear of transmission and inadequate knowledge could be improved with training

Outcomes of Botulinum Toxin Type A Injection Followed by Rehabilitation in Cases of Cerebral Palsy With Upper Extremity Involvement

Karaca, Burcu/0000-0003-2401-5445WOS: 000370429700014PubMed: 26239492We evaluated the efficiency of botulinum toxin type A injection followed by a rehabilitation program including individual therapy, group therapy, and occupational therapy in cases of cerebral palsy with upper extremity involvement. A total of 29 injections were performed on 25 patients, and the patients were placed on rehabilitation program. At 3-month and 6-month assessments, there was a significant improvement in lateral grip strength, 9 Hole Peg test, Upper Limb Physician's Rating Scale and pediatric functional independence measure total scores. There were significant decreases in active range of motion in elbow extension, supination, and wrist extension, and Modified Ashworth Scale in elbow flexion, elbow pronation, and wrist flexion at 6-week, 3-month, and 6-month assessments. Combination of group therapy with traditional therapy methods after injection is effective in cases of cerebral palsy with upper extremity involvement

Colorectal Cancer due to Constitutional Mismatch Repair Deficiency Mimicking Neurofibromatosis I

Colorectal carcinoma (CRC) is an extremely rare tumor of childhood that can be associated with cancer predisposition syndromes. A patient with CRC related to constitutional mismatch repair deficiency (CMMRD) syndrome with features of neurofibromatosis type 1 (NF-1) is presented here. A 13-year-old boy was admitted for a 4-month history of diarrhea and rectal bleeding. The patient had extensive cafe au lait spots, freckling, and Lisch nodules. He fulfilled the NF-1 diagnostic criteria. Colonoscopy showed numerous polyps and a colorectal mass lesion, of which a biopsy revealed adenocarcinoma, an uncommon pathology associated with NF-1. High microsatellite instability and homozygous mutation of PMS2 gene in tumor tissue and blood lymphocytes, respectively, confirmed the diagnosis of CMMRD. Unfortunately, because family history related to CMMRD was negative, the parents denied the diagnosis and refused the therapy, and the patient was lost to follow-up. CMMRD is a rare cancer predisposition syndrome with phenotypical features resembling NF-1. The disease may be suspected in the setting of NF-1 features and CRC, high-grade brain tumors, or hematologic malignancies. Lack of family history related to CMMRD may be a major obstacle to convincing parents of the presence of an inherited disease in their progeny

Intracranial Hemorrhage Due To Vitamin K Deficiency in Infancy: Clinical and Radiological Findings

WOS: 000264808100004This retrospective study presents clinical and radiological findings and outcomes of 25 infants with intracranial hemorrhage due to vitamin K deficiency and evaluates the risk factors. Two of the infants (8%) were classical type and the others were late onset. Of the patients, 18 (72%) were male and 7 (28%) were female. Twenty four infants (96%) were being fed exclusively on breast milk. Eighteen of them (72%) had not received vitamin K prophylaxis at birth. The most disabling clinical symptoms were vomiting (44%) and convulsions (40%). The most common presentations were bulging fontanel (40%) and paleness (40%). Eleven patients (44%) showed intracranial hemorrhages at more than one site. Intraparenchymal hemorrhage was the commonest (68%) type of hemorrhage. Twelve of cases (57%) were developmentally normal. Mortality rate was 8%. Late type is frequently associated with intracranial hemorrhage particularly intraparenchymal. Lack of administration of vitamin K at birth to breastfeed babies is the most important risk factor for intracranial hemorrhage