The Geometry of the Proximal Femoral Medullary Canal in German Shepherd and Kangal Dogs

The proximal femur has morphological variability that is related to its functional and biomechanical properties. Therefore, researchers have long been interested in these variations especially associated with the femoral implant design and implantation in total hip arthroplasty. The positions of the femoral head and the geometrical variations in the medullary canal are evaluated in particular to understand the proximal femoral morphology. The position of head or neck of the dog has already been studied in detail. There are incomplete data to evaluate variations in the geometry of the medullary canal of proximal femur in dog. Proximal femoral morphology of the medullary canal has been evaluated only at the coronal plane in dog studies using plain radiography. The morphometric data on the sagittal plane are also need to innovations in femoral implants. The purpose of this study is to indicate the detailed geometric data about proximal femoral canal of dog using three-dimensional morphometric methods to provide a database for the orthopedic studies. The effect of the breed with different pelvic limb conformation was also studied in this study. The cleaned femora from 16 German shepherd and 16 Kangal dogs were used. The three-dimensional images were reconstructed from the computed tomographic images. The femoral length, the anteversion angle and neck angles, the isthmus position and the widths on medio-lateral and cranio-caudal directions of the cross-sections of proximal femur were measured. The cortico-medullary indices, the isthmus position index and the canal flare indices were also calculated to detailed investigation of medullary canal of the proximal femur. According to our study results, it must be considered in stem design that the level of the isthmus might change in response to different conformations of the dog breeds, whilst the flare indices are similar in the dogs. The flare of the medullary canal was firstly evaluated with the cranio-caudal diameters on the three-dimensional images in this study. The cortico-medullary index shows some variation between the dog breeds across the levels and the directions of the cross-sections of the proximal femur. Nowadays, three-dimensional images can be acquired and morphometric measurements can be done easily by tomography in a lot of veterinary clinics. The data from three-dimensional morphometric analysis may contribute to the optimization of the design and preoperative selection of femoral implants by surgeons

A Neonatal Pneumonia Presented with Spontaneous Pneumothorax Due to Listeria Monositogenes

WOS: 000215587000025Listeria Monositogenes is a facultative anaerob gram(+) agents that presents in soil, water, plants and in many mammals intestinal system Usteria Monositogenes is one of the most common factors of early neonatal sepsis and neonatal pneumonia during the per natal period. Maternal obstetric complications are frequently seen in patients. Patients are often premature and have low birth weight. Responsible microorganisms frequently originate from maternal. The disease involes multisystems and the prognosis is usually fulminant. In the congenital pneumonia, respiratory distress syndrome is prominent. Symptomatic spontaneous pneumothorax brings about serious morbidity and mortality in newborns. The cause and risk factors of symptomatic pneumothorax in term newborns are not completely understood. The risk factors were reported as prematurity, male sex, high birth weight and birth the use of vacuum We aimed to present a case with neonatal pneumonia associated with symptomatic spontaneous pneumothorax due to Listeria Monositogenes

Etiologic Causes of Otitis Media with Effusion in Children

WOS: 000436147800006Introduction: Otitis media with effusion (OME) is one of the most common diseases in childhood. It is the most common reason of acquired hearing loss in pre-school childhood. We aimed to draw attention to the importance of diagnosing OME by otoscopic and tympanometric examination in early eras and to determine the risk factors in our cases. Methods: The present study was conducted in our hospital with a total of 31 OME children between the ages of 8 months and 6 years who were followed by the children's and otorhinolaryngology clinics between 2013 and 2014. The etiologic factors in patients who were detected with effusion by otoscopic and tympanometric examination were documented. Results: A total of 350 children were evaluated between the ages of 8 months and 6 years. Of the total, only 31 children (8.8%) were diagnosed with OME. The mean age of children was 27.1 +/- 16.9 months. Seventeen patients (54.8%) were males, and 14 patients (45%) were females. Twenty-nine had bilateral OME. Type B tympanogram curves were found in 54 (90%), and type C2 curves were found in 6 (10%) of all patients. The sensitivity of the skin prick test was found in 33.3% for one or more allergens. The skin prick test was positive in all cases in which eosinophil cationic protein levels were considered significantly positive. The adenoid tissue was larger than normal sizes in 13 (43.3%) patients. Conclusion: OME is a serious public health problem with leading conductive type hearing loss, retardation of speech, and developmental speech and language problems. Therefore, otoscopic examination is crucial in children in all hospital admissions for any reasons

A pediatric case of pituitary macroadenoma presenting with pituitary apoplexy and cranial nerve involvement: case report

WOS: 000388504700009PubMed: 27738402Pituitary adenomas usually arise from the anterior lobe of the pituitary gland and are manifested with hormonal disorders or mass effect. Mass effect usually occurs in nonfunctional tumors. Pituitary adenomas may be manifested with visual field defects or rarely in the form of total oculomotor palsy. Visual field defect is most frequently in the form of bitemporal hemianopsia and superior temporal defect. Sudden loss of vision, papilledema and ophthalmoplegia may be observed. Pituitary apoplexy is defined as an acute clinical syndrome characterized with headache, vomiting, loss of vision, ophthalmoplegia and clouding of consciousness. The problem leading to pituitary apoplexy may be decreased blood supply in the adenoma and hemorrhage following this decrease or hemorrhage alone. In this article, we present a patient who presented with fever, vomiting and sudden loss of vision and limited outward gaze in the left eye following trauma and who was found to have pituitary macroadenoma causing compression of the optic chiasma and optic nerve on the left side on cranial and pituitary magnetic resonance imaging

Okul Çağındaki Çocuklarda Demir, Çinko ve A Vitamini Eksikliği Prevalansının Değerlendirilmesi

Amaç: Demir, çinko ve A vitamini toplum sağlığı açısından önemli mikrobesinlerdir. Bu üç mikrobesin organizmadahücre bölünme ve farklılaşmasında, immünitede, kemik gelişiminde, görme, zeka ve algılama fonksiyonunda, anne veçocuk mortalitesinde etkilidir. Çalışmada, sağlıklı çocuklarda serum demir, çinko ve A vitamini eksikliği prevalansını veeksikliklerinin birbiriyle olan ilişkisini araştırdık.Gereç ve Yöntemler: Çalışmamızda Bülent Ecevit Üniversitesi Tıp Fakültesi Genel Çocuk Polikliniği’ne başvuran 6-14yaş arasındaki 174 kız, 160 erkek olmak üzere toplam 334 sağlıklı çocukta serum demir, çinko, A vitamini değerleri vetam kan sayımı çalışıldı.Bulgular: Demir eksikliği prevalansı %49.7, çinko eksikliği prevalansı %18.9, A vitamini eksikliği prevalansı %14.7saptandı. Serum demir, çinko ve A vitamini düzeyleri arasında istatistiksel olarak anlamlı ilişki saptanmadı. Demir eksikliğiolan ve olmayan olgular arasında çinko veya A vitamini eksikliği açısından istatistiksel olarak anlamlı fark saptanmadı.Kızlar ve erkekler arasında demir ve A vitamini eksikliği açısından istatistiksel olarak anlamlı fark saptanmadı. Çinkoeksikliği ise kızlarda %23.6 (n=41), erkeklerde %13.8 (n=22) olarak bulunmuş olup aradaki fark istatistiksel olarak anlamlısaptandı (p=0.022).Sonuç: Sağlam çocuklarda bile demir, çinko ve A vitamini eksikliğinin önemli boyutlarda olduğu görülmektedir. Özellikledemir eksiliği yürütülen çalışmalara, programlara rağmen halen yüksek oranlarda seyretmektedir. Türkiye’de mikrobesineksikliklerin sıklığının belirlenebilmesi için yeterli olgu sayısı ile değişik özellikte toplum örneklerinin incelenmesine ihtiyaçvardır.Objective: Iron, zinc and vitamin A are important micronutrients for public health. These three micronutrients have effects on cell division and differentiation, immunity, bone development, visual functions, intelligence and comprehension, and maternal and infant mortality. The purpose of this study was evaluate the prevalence of deficiencies of iron, zinc and vitamin A in healthy children and determine the relationship between the deficiencies. Material and Methods: Values of serum iron, zinc and vitamin A and complete blood counts were analyzed in 334 healthy children between 6-14 years of age, including 174 girls and 160 boys, who applied to Bülent Ecevit Medical Faculty, Pediatric Outpatient Clinic. Results: The prevalence of iron deficiency was 49.7%, the prevalence of zinc deficiency was 18.9%, and the prevalence of vitamin A deficiency was 14.7%. There was no statistically meaningful correlation between serum iron, zinc and vitamin A levels. There was no statistically significant difference in children with presence or absence of iron deficiency as regards zinc deficiency or vitamin A deficiency. There was no statistically significant difference with respect to deficiencies of iron or vitamin A between girls and boys. The rate of deficiency of zinc was found to be 23.6% (n=41) in girls and 13.8% (n=22) in boys which was statistically significant (p=0.022). Conclusion: As a result of this study, deficiencies of iron, zinc and vitamin A were observed although the children were healthy. The rate of iron deficiency was especially high despite programs to reduce it

Relationship between newborn craniotabes and vitamin D status

OBJECTIVE: In recent studies, vitamin D deficiency during pregnancy and early infancy has been reported to predispose children to many chronic diseases, except those of the skeletal system. The aim of this study was to investigate whether craniotabes in otherwise healthy newborns is physiological, its relationship to vitamin D deficiency and whether or not it requires treatment. METHODS: A total of 150 healthy newborns with a weight of over 2000 g were included. Newborns were divided into two groups during postnatal discharge (1-3.'s day): those with and without craniotabes. The 25-hydroxy (OH) vitamin D levels of the newborns' mothers were measured, and all infants were re-evaluated for craniotabes, as well as tested to determine levels of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), parathyroid hormone (PTH) and 25(OH) vitamin D, urine calcium and creatinine. RESULTS: Craniotabes was present in 45 (30%) of newborns enrolled in the study. Craniotabes of the newborns born during the winter months was significantly higher. PTH level was significantly higher in 1-month-old newborns with craniotabes than those without craniotabes. No relationship was observed between diet and craniotabes, but in exclusively breastfed infants, vitamin D level was statistically significantly lower. No statistically significant difference was found in the occurrence of craniotabes in newborns with or without vitamin D support.CONCLUSION: The relationship between newborn craniotabes and maternal vitamin D deficiency is not clear. However, the present study illustrates that maternal vitamin D deficiency is still a major problem. Therefore, measures to prevent maternal vitamin D deficiency should be strengthened.OBJECTIVE: In recent studies, vitamin D deficiency during pregnancy and early infancy has been reported to predispose children to many chronic diseases, except those of the skeletal system. The aim of this study was to investigate whether craniotabes in otherwise healthy newborns is physiological, its relationship to vitamin D deficiency and whether or not it requires treatment. METHODS: A total of 150 healthy newborns with a weight of over 2000 g were included. Newborns were divided into two groups during postnatal discharge (1-3.'s day): those with and without craniotabes. The 25-hydroxy (OH) vitamin D levels of the newborns' mothers were measured, and all infants were re-evaluated for craniotabes, as well as tested to determine levels of serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), parathyroid hormone (PTH) and 25(OH) vitamin D, urine calcium and creatinine. RESULTS: Craniotabes was present in 45 (30%) of newborns enrolled in the study. Craniotabes of the newborns born during the winter months was significantly higher. PTH level was significantly higher in 1-month-old newborns with craniotabes than those without craniotabes. No relationship was observed between diet and craniotabes, but in exclusively breastfed infants, vitamin D level was statistically significantly lower. No statistically significant difference was found in the occurrence of craniotabes in newborns with or without vitamin D support.CONCLUSION: The relationship between newborn craniotabes and maternal vitamin D deficiency is not clear. However, the present study illustrates that maternal vitamin D deficiency is still a major problem. Therefore, measures to prevent maternal vitamin D deficiency should be strengthened

Effect of Prophylactic Antibiotic Use in the Development of Antibiotic Resistance in Children with Recurrent Urinary Tract Infections

WOS: 000423909700010Aim: Although prophylactic antibiotic treatment is still debatable, it is currently in use in recurrent urinary tract infections (UTIs). In the present study, we aimed to observe if prophylactic antibiotic use had any effect on the development of antibiotic resistance in patients with recurrent UTIs who we followed up in our clinic. Methods: The present study was performed on patients aged between one month and 16 years, who had recurrent UTIs, and were followed up by the Department of Pediatrics at Bulent Ecevit University Medical School. Patient files were retrospectively reviewed, and 50 patients who received antibiotic prophylaxis and 100 patients without prophylaxis were enrolled in the study. Urinary tests, subsequent urinary culture results, and antibiotic resistances were compared between the groups. Results: The mean age was 42.7 +/- 44.2 months. The most frequently cultured isolated bacterium was Escherichia coli (E. coli) (58.4%). No difference was determined in bacteria in cultures between prophylaxis receivers and non-receivers. Isolation rate of E. coli was higher in urinary cultures in females than in males (p<0.001). When antibiotic resistance of all urinary culture-isolated bacteria was compared between the two groups, there was no statistically significant difference. However, an increased resistance against amoxicillin/clavulanic acid, ceftriaxone, and piperacillin was determined in prophylaxis group in whom E. coli was grown. In this study, general antibiotic resistance was most frequently observed against ampicillin (71.9%). Conclusion: In the present study, we observed that prophylaxis did not contribute so much to resistance other than E. coli. We recommend not preferring antibiotics which have increased resistance in our institution especially in children receiving prophylaxis for empirical treatment