Çocukların Beslenme, Büyüme, Gelişme ve Aşı Takibini Etkileyen Sosyodemografik Faktörlerin Araştırılması

Amaç: Sağlıklı çocuk izlemi temel sağlık hizmetlerinin önemli bir parçasıdır. Amaç doğumdan sonra süt çocukları ve çocukların beslenme, büyüme ve gelişme ve aşılama gibi sağlık parametrelerini değerlendirmektir. Bu hizmet doktor, hemşire ve aileden oluşan bir ekip tarafından yapılabilir. Çalışmada bölgemizdeki çocukların yaşamlarının ilk 6 ayındaki beslenme, büyüme ve gelişme ve aşı takibini etkileyen sosyodemografik faktörlerin araştırılması amaçlandı.Gereçler ve Yöntem: Çalışma bir anket çalışması olarak planlandı. Sağlam çocuk polikliniğine başvuran çocukların ailelerine anket uygulandı. Beslenme, büyüme ve gelişme ve aşılanma durumu değerlendirildi. Ankette anneye ve annenin ilk 6 aydaki beslenme, büyüme ve gelişme ve aşılama hakkındaki tutumlarını değerlendiren 12 soru, baba ile ilgili 7 soru ve çocuk ve kardeşlerle ilgili 9 soru mevcut idi. Ailenin ekonomik durumunu değerlendirmek üzere ilave sorular mevcut idi. Lokal etik komite çalışmayı onadı.Ailelerden bilgilendirilmiş onam alındı.Bulgular: Çalışmaya toplam 452 çocuk (erkek=232) dahil edildi. Hastaların ortalama yaşı 2,61±1,45 yıl idi. Doğumdan itibaren anne sütü alma oranı %95,5, ilk 6 ayda yalnızca anne sütü ile beslenme oranı %65, anne sütü ve formula ile beslenme oranı %30,5 ve sadece formula ile beslenme oranı %4,4 oranında idi. Hastaların tümüne tüm aşılar yapılmış idi (%100). Hastaların %62,4’ünün büyüme gelişme kontrolünün düzenli olduğu saptandı. Bir kısım faktörlerin düzenli büyüme gelişme kontrolü üzerine pozitif etkisi olduğu belirlendi; ailenin eğitim düzeyinin yüksek olması (p37 hafta olması (p37 weeks (p<0,05), higher economical status (p<0,01). While some had negative effect; receiving training from family members (p<0,01), father smoking (p<0,01), increasing child number (p<0,01), crowded family (P<0,05), lower social security (green card) (p<0,01). Conclusion: The sociodemographic factors that affect the healthy child monitorisation should be evaluated in all regions. By correcting the negative conditions, the feeding, growth and development and vaccination status of the infants and children after birth can be improved

Greig sefalopolisindaktili sendromu: Bir olgu sunumu

Introduction: The Greig cephalopolysyndactyly syndrome (GCPS) is a pleiotropic, multiple congenital anomaly syndrome. Case Report: The patient had high forehead, frontal bossing, macrocephaly, apparent hypertelorism, down-slanting palpebral fissures and a broad nasal root. The feet showed bilateral polydactyly with cutaneous syndactyly of the fifth digits. Conclusion: GCPS is a rare condition with an autosomal dominant mode of inheritance. The primary findings include hypertelorism, macrocephaly with frontal bossing, and polysyndactyly. Presented here is a case of a 1 week old female with typical clinical manifestations of GCPS.Giriş: Greig sefalopolisindaktili sendromu (GCPS), çoklu konjenital anomalili bir pleiotropik sendromdur. Olgu Sunumu: Hasta yüksek alın, frontal şişlik, makrosefali, belirgin hipertelorizm, aşağı eğik palpebral fissürler ve geniş bir burun köküne sahipti. Ayakları bilateral kutanöz sindaktilili polidaktili gösterdi. Tartışma: GCPS otozomal dominant genetik modelli nadir bir durumdur. Primer bulguları, hipertelorizm, frontal şişliği olan makrosefali ve polisindaktiliyi içerir. Burada, GCPS’nin tipik klinik bulguları ile 1 haftalık kız bir olgu sunuldu

Relationship Between Hemodynamically Significant Ductus Arteriosus and Ischemia-Modified Albumin in Premature Infants

Hemodynamically significant ductus arteriosus (hsPDA) may alter organ perfusion by interfering blood flow to the tissues. Therefore, in infants with hsPDA, hypoxia occurs in many tissues. In this study, we aimed to investigate the diagnostic significance of serum (ischemia-modified albumin) IMA levels as a screening tool for hsPDA, and its relation to the severity of the disease in the preterm neonates. For this purpose, seventy-two premature infants with gestation age <34 weeks were included in the study. Thirty premature infants with hsPDA were assigned as the study group and 42 premature infants without PDA were determined as the control group. Blood samples were collected before the treatment and 24 h after the treatment, and analyzed for IMA levels. IMA levels in the study group (1.26 +/- 0.36 ABSU) were found to be significantly higher than control group (0.65 +/- 0.12 ABSU) (p < 0.05). In infants with hsPDA, a positive correlation was found between IMA and PDA diameter (rho = 0.876, p = 0.022), and LA/Ao ratio (rho = 0.863, p = 0.014). The cut-off value of IMA for hsPDA was measured as 0.78 ABSU with 88.89 % sensitivity, and 90.24 % specificity, 85.71 % positive predictive, 92.5 % negative predictive value [area under the curve (AUC) = 0.96; p < 0.001]. The mean IMA value of the infants with hsPDA before treatment was 1.26 +/- 0.36 ABSU, and the mean IMA value of infants after medical treatment was 0.67 +/- 0.27 ABSU (p = 0.03). We concluded that IMA can be used as a marker for the diagnosis and monitoring of a successful treatment of hsPDA

Assessment of heart rate variability in breath holding children by 24 hour Holter monitoring

Purpose: Previous studies have shown that the underlying pathophysiologic mechanism in children with breath holding may be generalised autonomic dysregulation. Thus, we performed cardiac rhythm and heart rate variability analyses using 24-hour Holter monitoring to evaluate the cardiac effects of autonomic dysregulation in children with breath-holding spells. Methods: We performed cardiac rhythm and heart rate analyses using 24-hour Holter monitors to evaluate the cardiac effects of autonomic dysregulation in children during a breath-holding spell. Our study group consisted of 68 children with breath-holding spells -56 cyanotic type and 12 pallid type -and 39 healthy controls. Results: Clinical and heart rate variability results were compared between each spell type - cyanotic or pallid - and the control group; significant differences (p 50 ms, and square root of the mean of the sum of squares of the differences between adjacent NN intervals values were found between the pallid and cyanotic groups. Conclusions: Holter monitoring for 24 hours and heart rate variability parameters, particularly in children with pallid spells, are crucial for evaluation of cardiac rhythm changes

Oral Sildenafil and Inhaled Iloprost in the Treatment of Pulmonary Hypertension of the Newborn

ObjectiveThis study was performed to examine the effectiveness and safety of oral sildenafil and inhaled iloprost in term newborns with persistent pulmonary hypertension of the newborn (PPHN)

Dilated cardiomyopathy secondary to rickets-related hypocalcaemia: eight case reports and a review of the literature

Introduction: Dilated cardiomyopathy is usually idiopathic and may arise secondary to infections or metabolic or genetic causes. Another rare cause is hypocalcaemia. Owing to the fact that calcium plays an essential role in excitation and contraction of myocardial muscle, myocardial contractility may decline in patients with hypocalcaemia. Materials and Methods: Patients with symptoms of congestive heart failure and rickets-related hypocalcaemia were assessed clinically and by echocardiography in a paediatric cardiology clinic. Echocardiography was performed for all patients. Rickets was diagnosed according to the clinical, laboratory, and radiologic findings. Maternal lifestyle and living conditions were investigated, and the maternal 25-OH vitamin D-3 blood level was measured. Results: We evaluated eight patients who developed heart failure as a result of severe hypocalcaemia associated with rickets between August, 1999 and June, 2012. The age distribution of the patients was 3-12 months. Laboratory results were consistent with advanced-stage rickets. Severe hypocalcaemia was detected in all patients. The maternal 25-OH vitamin D-3 levels were low. Echocardiography revealed increased pre-treatment left ventricle end-systolic and end-diastolic diameters for age and reduced ejection fraction and fractional shortening. After clinical improvement, the patients were discharged. Conclusions: Severe hypocalcaemia associated with rickets must always be kept in mind among the causes of dilated cardiomyopathy and impaired cardiac function in infants. If diagnosed and treated in time, dilated cardiomyopathy and severe heart failure related to rickets respond well

Fasting and postprandial glucose, insulin, leptin, and ghrelin values in preterm babies and their mothers: relationships among their levels, fetal growth, and neonatal anthropometry

Objective: To investigate relationship between anthropometric values of premature babies with their's glucose, insulin, leptin, and ghrelin at birth and on day 15