PNEUMOTHORAX IN NEWBORN: OUR EXPERIENCE

Amaç: Yenidoğan döneminde solunum sıkıntısı yapan nedenlerden biri de pnömotoraks olup, mekanik ventilasyon tedavisi, mekonyum aspirasyonu sendromu, solunum güçlüğü sendromu ve perinatal asfiksi nedeniyle canlandırma işlemi uygulanan olgularda gelişme riski yüksektir. Hastanemiz yenidoğan bakım ünitesinde semptomatik pnömotoraks saptanarak tedavi edilen olgular geriye dönük olarak incelenmiştir. Gereç ve yöntem: Ocak 2003-Ocak 2006 tarihleri arasındaki 7 pnömotorakslı olguda gestasyonel yaş, ağırlık, aminon sıvısının mekonyumla boyalı olup olmadığı, primer akciğer patolojisi varlığı ve pnömotoraksın tarafı değerlendirildi. Tanıda akciğer grafisi ve bazı olgularda konjenital anomali varlığını araştırmak için bilgisayarlı tomografi yapıldı. Toraks drenaj işlemi için 10 F tüp kullanıldı. Bulgular: 7 olgunun değerlendirilmesinde; pnömotoraks insidansı %1,2 (7/570), erkek kız oranı 1,3, başvuru zamanı 10 saat ile 6 gün idi. 5 hasta (%71,4) prematürdü. Pnömotoraks sağda 3 (%42,9), bilateral 4 (%57,1) vakada mevcuttu. Serimizde mortalite % 57,1 olarak bulunmuştur. Vefat eden olguların büyük bir kısmı (%75) prematüre, solunum güçlüğü sendromlu ve iki taraflı pnömotoraksı olan olgulardı. Sonuç: Yenidoğan pnömotoraks olgularında mortalitenin prematürite, SGS ve iki taraflı pnömotoraks varlığında yüksek olması literatür ile uyumlu bulundu. Objective: Pneumothorax is one of the important etiologic factors in newborn which causes respiratory distress. Pneumothorax usually occurs in newborns under mechanical ventilation. Respiratory distress syndrome, meconium aspiration syndrome and resuscitation after birth may also cause pneumothorax. We retrospectively reviewed patients who were hospitalized for pneumothorax in our newborn intensive care unit. Material and method: Between January 2003 and January 2006, 7 cases were treated for pneumothorax. These cases were analyzed according to gestational age, existence of meconium in the amniotic fluid, primary lung pathology, weight, and side of pneumothorax. The relation between these criteria and the mortality was investigated. 10 F tube were used for thoracostomy. The diagnosis was made by chest x-rays, computerized tomography was used to examine presence of congenital anomalies. Results: The incidence of pneumothorax in the neonates treated in our intensive care unit is found to be 1,2 % (7/570). M:F ratio was 1.3. Age of admittance ranged from 10 hours to 6 days. Five patients (71,4) were premature. Pneumothorax was present at right hemithorax in 3 (42,9%) while 4 patients (%57,1) were bilaterally affected. Mortality rate was 57,1%. Most of the patients who died were premature (75%) and had bilateral pneumothorax. Conclusion: Also seen in the literature, we found that the mortality rate was higher in premature, RDS patients and the patients who had bilateral pneumothorax

Herpes zoster infection in early adolescence: two case reports and review of the treatment approach

Introduction: Herpes zoster is a skin infection caused by reactivation of the Varicella zoster virus that remains latent in the dorsal root ganglia, showing dermatomal spread on the skin, accompanied by a vesicular rash and itching. It is a disease of the adult age group. Although herpes zoster is more common in immunocompromised children, it is rarely seen in healthy children. Case Presentation: Two patients, 11 and 12 years old, presented with pain, itching, and rash. Patient histories indicated that they were previously healthy. Alanine aminotransferase, aspartate aminotransferase, urea, blood urea nitrogen, creatinine, and electrolyte values were within normal limits. Varicella-zoster virus (VZV) immunoglobulin (Ig) G and VZV Ig M were positive, while herpes zoster virus (HZV) Ig G and HZV Ig M were negative. Oral acyclovir treatment was started. Symptoms, treatment, and follow-up of the two cases were similar. In both patients, the lesions regressed within a week, and at the end of the second week, they recovered without complications.Conclusion: Herpes Zoster infection is rarely seen in healthy children. In this case report, we aimed to remind and discuss the clinical features during childhood

A newborn with Cornelia de Lange syndrome: a case report

Cornelia de Lange syndrome (CdLS) is a rarely seen multisystem developmental disorder syndrome characterized by facial dysmorphia (arched eyebrows, synophrys, depressed nasal bridge, long philtrum, down-turned angles of the mouth), upper-extremity malformations, hirsutism, cardiac defects, growth and cognitive retardation, and gastrointestinal abnormalities. The features of this disorder vary widely among affected individuals and range from relatively mild to severe. Early in life, the distinctive craniofacial features in mild de Lange syndrome may be indistinguishable from the severe (classical) phenotype. We present here a case of newborn with CdLs

USE OF INTRAVENOUS LIPID EMULSION THERAPY IN A CASE OF ATOMOXETINE (STRATTERA (R)) TOXICITY

Background: Clinical manifestations after overdose of atomoxetine are generally mild. However, it may have moderate or severe toxic effects such as drowsiness, agitation, hyperactivity, tremors, tachycardia, hyperreflexia, hypertension, and seizures. The duration of symptoms is usually short, lasting < 24 h. We report a case of atomoxetine toxicity, which can be considered of value, as intravenous lipid emulsion therapy has not been previously reported in an overdose of atomoxetine. This is a case of atomoxetine toxicity initially thought to be sertraline. Case Report: The case is presented of a 14-year-old girl with seizures following an overdose of atomoxetine who was unresponsive to intravenous benzodiazepine, but showed an improvement in overall condition after intravenous lipid emulsion therapy. To the best of our knowledge, there has been no previous report in the literature of the use of intravenous lipid therapy after atomoxetine overdose. Why Should an Emergency Physician Be Aware of This?: Intravenous lipid emulsion therapy is used as an alternative therapy in acute lipophilic drug intoxications. In children and adults, there is an increase in the use of intravenous lipid emulsion therapy in the life-threatening toxicity of many lipophilic drugs. Intravenous lipid emulsion therapy provides 'lipid sink' for toxic, lipophilic drugs, thereby effectively keeping toxic and lipophilic drugs out of the periphery. Intravenous lipid emulsion therapy reduces the distribution of lipophilic drugs. (C) 2020 Elsevier Inc. All rights reserved.WOS:0005726772000032-s2.0-85085772010PubMed: 3250544

A NOVEL MUTATION K447M (P.LYS447MET, C.1340 A>T) IDENTIFIED IN EXON 4 OF THE MEFV GENE

WOS: 000395220800012PubMed: 30226974

Assessment of magnesium status in newly diagnosed diabetic children: measurement of erythrocyte magnesium level and magnesium tolerance testing

WOS: 000230607400006PubMed: 16052852The aim of this study was to investigate the relationship between serum, erythrocyte and urine magnesium levels and retained magnesium percentage in newly diagnosed diabetic children. In a cross-sectional study, 34 children with insulin dependent diabetes mellitus (IDDM) and 21 healthy age- and sex-matched control subjects were screened for their serum, erythrocyte, and urine magnesium levels. Magnesium tolerance test was performed on diabetic and control subjects: Serum and erythrocyte magnesium levels in diabetic children were significantly lower than in healthy controls (plasma magnesium, p < 0.05; erythrocyte magnesium, p < 0.001); however, serum magnesium level was in normal range in diabetics and controls. Erythrocyte magnesium levels in diabetic children showed an inverse correlation with percentage of retained magnesium load (r=-0.44, p < 0.01). Urine magnesium excretion in diabetic children (7.12 +/- 2.18 mmol/g creatinine/24-hr) was significantly higher than in healthy controls (4.0 +/- 1.35 mmol/g creatinine/24-hr) (p < 0.001). There was a negative correlation between erythrocyte magnesium (2.07 +/- 0.62 mmol/L) and urine magnesium (7.12 +/- 2.18 mmol/g creatinine/24-hr) (r=-0.68 p < 0.01) in diabetic children. Magnesium tolerance test showed that percentage of retained magnesium in diabetic children (66 +/- 26%) was significantly higher than in controls (16 +/- 7%) (p < 0.001). This study is the first study to simultaneously investigate serum, erythrocyte and urine magnesium levels and magnesium tolerance test in newly diagnosed diabetic children. In conclusion, erythrocyte magnesium levels decrease earlier than serum magnesium in diabetic children. The follow-up parameters in diabetics may include the policy of monitoring magnesium status. Erythrocyte magnesium measurement is preferred to serum magnesium. Magnesium tolerance test is a reliable and sensitive method, which may be used as an alternative to erythrocyte magnesium measurement or in combination with it in hospitalized diabetic children

Investigation of Vitamin D Deficiency inPre-School Children During Summer Season

Aim:Vitamin D deficiency is an important public health problem, especially affecting children. Theaim of our study is to evaluate the serum 25 (OH) vitamin D levels of children during the summer and to determine some features such as exposure to the sun, oral vitamin D supplementation, and to examine the parameters that affect serum vitamin D levels.Methods:In our study, children aged between 12 and 83 months were included. A questionnaire was answered by families. In this cross-sectional study, serum 25 (OH) vitamin D levels of children and biochemical parameters were examined.Results:The mean serum 25 (OH) vitamin D level was 27.0±12.4 ng/ml. Vitamin D deficiency was found 17%, and vitamin D insufficiency was 6%. The children that taking daycare indoors and body mass index <5th percentile had lower serum 25 (OH) vitamin D levels. Children between the ages of 12-36 months and children with chronic diseases were found to have a shorter time to benefit from sunlight.Conclusion: The rate of vitamin D deficiency and insufficiency (<20 ng/ml) in children were found at 23% in summer season. Families and caregivers should be informed about vitamin D and should be aware of safe sun exposure.2-s2.0-8511960514

Evaluation and Management of Severe Childhood Anemia: A Single Center Experience

Aim: The aim of this study was to determine the frequency of iron deficiency anemia inpatients with severe anemia, and to investigate and compare the difference in the hematologicalparameters between patients with and without iron deficiency anemia.Material and Methods: A total of 119 patients diagnosed with severe anemia between January2012 and July 2014 were retrospectively analyzed in this study. Demographic and clinicalcharacteristics of severe anemia patients were evaluated. Patients were evaluated in terms ofiron deficiency anemia, and clinical characteristic and laboratory findings of the patients withand without iron deficiency anemia were compared.Results: Of the 119 cases 49 (41.2%) were male and 70 (58.8%) were female, mean age was6.7±6.2 years. Various comorbidities were present in the patients. In all patients, the groupwith a hemoglobin value below 6 g/dL had a significantly lower platelet count than those equalto or above 6 g/dL (p=0.037). It was found that 52 (43.7%) of all cases had iron deficiencyanemia and 27 (51.9%) of them were aged 5 to 18 years. Patients with iron deficiency anemiahad lower ferritin level (p<0.001) than patients without iron deficiency anemia, while plateletcount was higher in patients with iron deficiency anemia (p=0.001).Conclusion: In patients with severe anemia, a significant decrease in platelet count was foundwith hemoglobin value below 6 g/dL. In order to reduce the need for red blood cellstransfusion, early diagnosis of iron deficiency anemia is important and iron supplementationshould be given earlier.Amaç: Bu çalışmanın amacı derin anemisi olan hastalarda demir eksikliği anemisi sıklığını belirlemek ve demir eksikliği anemisi olan ve olmayan hastalar arasında hematolojik parametrelerdeki farklılığı incelemek ve karşılaştırmaktır. Gereç ve Yöntemler: Bu çalışmada Ocak 2012 ve Temmuz 2014 tarihleri arasında derin anemi tanısı almış olan toplam 119 hasta geriye dönük olarak incelendi. Derin anemi hastalarının demografik ve klinik özellikleri değerlendirildi. Hastalar demir eksikliği anemisi açısından değerlendirildi ve demir eksikliği anemisi olan ve olmayan hastaların klinik özellikleri ve laboratuvar bulguları karşılaştırıldı. Bulgular: Yüz on dokuz olgunun 49 (%41,2)’u erkek, 70 (%58,8)’i kız olup ortalama yaş 6,7±6,2 yıl idi. Hastalarda çeşitli eş zamanlı hastalıklar vardı. Tüm hastalarda, hemoglobin değeri 6 gr/dL’nin altında olan grup, 6 gr/dL’ye eşit ve üstünde olanlara göre anlamlı şekilde daha düşük trombosit sayısına sahipti (p=0,037). Tüm vakaların 52 (%43,7)’sinde demir eksikliği anemisi olduğu bulundu ve bunların 27 (%51,9)’si 5 ile 18 yaş arasında idi. Demir eksikliği anemisi olan hastaların ferritin düzeyi demir eksikliği anemisi olmayan hastalara göre daha düşük (p<0,001) iken, trombosit sayısı ise demir eksikliği anemisi olan hastalarda daha yüksekti (p=0,001). Sonuç: Derin anemili hastalarda, hemoglobin değerinin 6 g/dL’nin altında olması durumunda trombosit sayısında anlamlı düşüş saptanmıştır. Eritrosit transfüzyonu ihtiyacını azaltmak için, demir eksikliği anemisinin erken teşhisi önemlidir ve demir takviyesi daha erken yapılmalıdır.2-s2.0-8508539706