An uncommon cause of anterior knee pain in a child: Osteoid Osteoma of the patella and a review of the literature

Introduction: Osteoid osteoma (OO) is a small, benign bone neoplasm that has a well demarcated nidus surrounded by a reactive zone of sclerosis. It is most common in the long bones and only rarely in the patella.Case Presentation: An eight-year-old girl was admitted to the outpatient clinic with the complaint of anterior knee pain. She had been suffering from pain for approximately one year. The patient had a patellar osteoid osteoma. Surgical curettage of the lesion was performed, and the patient was free of pain the day after the surgery.Conclusions: Although Patellar OO is rare, it should be included in the differential diagnosis of persistent knee pain in children and young adults.Keywords: Osteoid Osteoma, patella, knee pain, curettage, delayed diagnosis, bone neoplasm

Permanent resiprokan kavşak taşikardisine bağlı dilate kardiyomiyopati: Bir olgu sunumu

We present a four-year-old girl who was admitted to our hospital with the complaints of dyspnea, tachypnea, cough, excess sweating and fatigue. Electrocardiogram (ECG) in the tachycardic girl showed inverted P waves in leads 2, 3 and aVF along with a P-R interval of 0.16 sec and an R-P interval of 0.28 sec. Transthoracic echocardiography revealed an enlarged and spherical left ventricle with diminished systolic functions. Holter ECG confirmed long R-P tachycardia with a rate of 140-160 beats/minute. She was diagnosed as having permanent junctional reciprocating tachycardia-induced dilated cardiomyopathy and successfully treated with catheter ablation and flecainide.Bu olgu sunumunda hastanemize dispne, takipne, öksürük, aşırı terleme ve yorgunluk yakınması ile başvuran dört yaşında kız olgu sunduk. Taşikardik olan hastanın elektrokardiyografisinde (EKG) V2, V3 ve aVF derivasyonlarında ters P dalgaları ile birlikte 0,16 sn P-R aralığı ve 0,28 sn R-P aralığı mevcuttu. Transtorasik ekokardiyografide sistolik fonksiyonları azalmış, geniş ve sferik sol ventrikül saptandı. Holter EKG'de kalp hızı 140-160/dk olan uzun R-P intervalli taşikardi konfirme edildi. Hastaya permanent resiprokan kavşak taşikardisine bağlı dilate kardiyomiyopati tanısı kondu ve hasta kateter ablasyonu ve flekainamid tedavisi ile başarılı bir şekilde tedavi edildi

Delayed time of atrial conduction in children with Familial Mediterranean Fever

Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.In the present study we aimed to assess atrial conduction time in children with FMF.Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P lt;0.001,respectively). (PA: the time range between the beginning of the P wave in the surface electrocardiogram and the beginning of the tissue Doppler late diastolic wave A). Also, P-wave dispersion (Pdisp) were significantly higher in FMF patients( p= 0.002).Conclusions: This study shows that atrial electromechanical delay and Pdisp are prolonged in children with FMF. We recommend that atrial conduction time be measured for children diagnosed with FMF

Isovaleric Acidemia Presenting as Diabetic Ketoacidosis: A Case Report

Isovaleric acidemia (IVA) is characterized by periodic vomiting, lethargy, coma, ketoacidosis and a ‘sweaty feet’ odor. Hyperglycemia, ketonemia, ketonuria and metabolic acidosis are the main clinical features of diabetic ketoacidosis (DKA) and these same symptoms can also be seen in acute attacks of metabolic diseases. We report a 2-year-old patient who presented with acute encephalopathy, hyperglycemia, metabolic acidosis, increased anion gap, ketosis and a preliminary diagnosis of DKA. Further investigation revealed IVA. This case is of interest because of the rarity of this presentation and detection of a splicing mutation in the isovaleryl-CoA dehydrogenase gene.PubMedWoSScopu

Delayed time of atrial conduction in children with Familial Mediterranean Fever

Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.In the present study we aimed to assess atrial conduction time in children with FMF.Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P lt;0.001,respectively). (PA: the time range between the beginning of the P wave in the surface electrocardiogram and the beginning of the tissue Doppler late diastolic wave A). Also, P-wave dispersion (Pdisp) were significantly higher in FMF patients( p= 0.002).Conclusions: This study shows that atrial electromechanical delay and Pdisp are prolonged in children with FMF. We recommend that atrial conduction time be measured for children diagnosed with FMF

Left ventrİcular noncompaction and ventricular tachycardia diagnosed at preparticipatİon screening

Sol ventrikül nonkompaksiyonu (LVNC), sol ventrikülün aşırı trabekülasyonu veya miyokardın süngerimsi özellikte olması ile karakterize nadir bir genetik kardiyomiyapatidir. Kalp yetersizliği, inmeyi de içeren tromboembolik olaylar, ventriküler aritmiler ve Wolf-Parkinson-White sendromu hastalığın önemli komplikasyonlarıdır. Bu çalışmada spor öncesi rutin fizik muayenesinde aritmisi farkedilen, yapılan tetkiklerinde sol ventriküler nonkompaksiyonu ve ventriküler taşikardi saptanan, radyofrekans ablasyon ve flekainid ile başarılı bir şekilde tedavi edilen bir olgu sunulmuştur.Left ventricular noncompaction is a rare genetic cardiomyopathy which is characterized by excessive trabeculated and spongioform left ventricule. Heart failure, thromboembolism including stroke, ventricular arrhythmia and Wolf Parkinson White Syndrome are the main complications. In this study we present a patient with arrhythmia diagnosed during preparticipation screening and succesfully treated with radiofrequency ablation and flecainide

Mean Platelet Volume and Ischemia Modified Albumin Levels in Cord Blood of Infants of Diabetic Mothers

Gestational diabetes mellitus (GDM) is a risk for the health of both the pregnant women and her infant. Its unfavorable effects start in utero and continue after birth. It is known that GDM increases oxidative stress and decreases antioxidant enzyme activities. In this study we aimed to investigate cord blood mean platelet volume (MPV) and ischemia-modified albumin (IMA) levels of infants of diabetic mothers (IDM). Methods: Twenty-nine pregnant women with GDM between 37 and 41 gestational weeks who gave birth by spontaneous vaginal delivery were enrolled as study participants together with 20 healthy pregnant women as a control group. Weight, length, and head circumference of babies were measured by the same standard tape immediately after birth. Five milliliters of umbilical venous blood were obtained to study MPV and IMA levels. Results: There was statistically significant difference in levels of MPV (p = 0.037) and IMA (p < 0.001) between groups. They increased in IDM compared with their healthy peers. Conclusion: Evaluation of MPV and IMA together is useful for representing the potential oxidative stress of IDM

Multi-Vitamin Intake During Pregnancy: Is it a Causative Factor for Childhood Obesity?

Aim: This study was conducted to investigate whether multivitamin intake can be one of the reasons of childhood obesity. Material and Method: : We carried out a prospective case-control study. The first group included 50 children, as case group who was diagnosed with obesity according to body mass index (BMI) and the second group 50 healty children as control group. Premature babies, children with mental motor reterdation and chronic illness, syndromic children and mothers who couldn't answer the questions efficiently were excluded. The study was conducted with a questionnaire that was filled out by mothers. Anthropometric measurements including body weight and height were measured by the same researcher (NK). Results: The mean age of the case group was 10,34 +/- 3,68 years and 8,88 +/- 3,96 years in control group. There were no statistically significant difference between two groups in terms of multivitamin intake during pregnancy so multivitamin intake was not found related with childhood obesity, mode of delivery, gestational age at delivery and birth weight as well. Discussion: In our study; multivitamin supplements had no effect on childhood obesity. Further studies are needed with larger populations to asses it detailed