A prospective study of serum concentrations of leptin, homocysteine and insulin resistance in children with steroid-sensitive nephrotic syndrome

Aim: To measure serum leptin, homocysteine concentrations and insulin resistance in active and remission stages of children with nephrotic syndrome (NS) and to investigate their role in NS pathogenesis. Methods: A total of 70 children were included in the study, 40 patients who had been diagnosed with NS and 30 healthy patients were control. Changes in plasma concentration of the serum homocysteine, leptin, and insulin were measured and compared with the other parameters in the groups. Results: Serum leptin concentrations in active phase were lower than the remission phase (1.48 ± 0.09 ng/dl, 1.84 ± 1.64 ng/ml, p<0.05). Also, serum homocysteine concentrations in NS group during the active phase were lower than the remission phase and the control group (6.45±2.54 ng/dl, 9.35±2.99 ng/ml, 7.76± 1.97 ng/ml, p<0.05). The serum fasting insulin concentrations and homeostatic model assessment for insulin resistance (HOMA-IR) values of remission phase were significantly higher than those of active phase (p<0.05). A positive relationship was found between the homocysteine concentrations and the body mass index of the patient; whereas, a negative relationship was detected between erythrocyte sedimentation rate (ESR), and the LDL-cholesterol concentrations (p<0.05). ESR was found as the only factor associated with lower concentrations of homocysteine during the active phase (r:-0.592, p<0.05).  Conclusion: In this study, we demonstrated that serum leptin and homocysteine concentrations decreased in active phase and increased in remission phase in children with NS.  Insulin resistance could also develop as a result of steroid use in a short period of time in these patients

Serum Antioxidative Enzymes Levels and Oxidative Stress Products in Children and Adolescents with Type I Diabetes Mellitus

Aim:Type I diabetes mellitus (TIDM) is an oxidative stress condition in addition to being a chronic metabolic disease. In this study, our aim is to investigate the activity of antioxidative enzymes and the products of oxidative stress in children and adolescents with TIDM and compare the findings with those in healthy control subjects.Materials and Methods:The study enrolled 41 children and adolescents with TIDM (mean age 11.4±3.3 years; 21 female, 20 male) and 25 healthy subjects (mean age 11.3±3.1 years; 8 female, 17 male) with a similar age and gender distribution. Serum samples were obtained to detect the antioxidative enzymes of paraoxonase (PON), arylesterase (ARE), oxidation degradation products of malondialdehyde (MDA) and also zinc which acts as an antioxidant.Results:We found a significant decrease in PON activity and zinc levels in diabetics compared to the healthy controls (p=0.021; p<0.001, respectively). Zinc was negatively correlated to hemoglobin A1c (r=-0.317, p=0.049). MDA and ARE did not show a significant difference in the TIDM patients compared to the healthy subjects.Conclusion:Zinc level and PON activity were lower in diabetic children and adolescents. Further studies with larger samples are required to confirm their roles in the following and prognosis of TIDM

The Role of Infections in Atopic Diseases in Children

Aim:Especially in the developed countries; there has been an increase in the prevalence of atopic diseases over the past 40 years. This is explained by the improved living conditions and reduced exposure to infections. In this study, effects of some infections on atopic diseases were investigated.Methods:Fifty atopic patients and 46 age-and sex-matched healthy children were included in the study. Skin prick test was performed and serum immunoglobulin (Ig) E levels were determined in all subjects. Serum-specific IgG was investigated to detect seropositivity of hepatitis A virus (HAV), Toxoplasma gondii, Epstein-Barr virus (EBV) and cytomegalovirus (CMV). In addition, Helicobacter pylori feacal antigen test was done.Results:Anti-HAV IgG seropositivity (30.0%) and H. pylori antigen positivity (22.0%) were significantly lower in atopic children than in controls (52.1%, 47.8%, respectively). There was no statistically significant difference between the two groups in seropositivities of T. gondii, EBV viral capsid antigen and CMV IgG.Conclusion:HAV and H. pylori may be protective infections in atopic patients. However, there is a need for larger scale studies to achieve generalizable results

Two Cases of an Unusual Childhood Aortic Dissection Resulting in Death

Pediatric aortic dissection is an emergency condition that is difficult to diagnose and is associated with high morbidity and mortality. To draw attention to this issue, we present two male cases diagnosed with aortic dissection because of an autopsy. A 16-year-old man with severe new-onset chest pain had an unremarkable physical examination, electrocardiography, and laboratory values. Aortic dissection was not detected on non-contrast computed tomography or echocardiography. Type A aortic dissection was discovered during the patient's autopsy. In the second case, a 10-year-old male patient complained of fever, vomiting, and abdominal pain. The physical examination and biochemical tests were unremarkable. Type B aortic dissection was discovered during the autopsy. Genetic and congenital causes predisposing to aortic dissection and hypertension or a history of trauma were not detected in either patient. Aortic dissection, which is very rare in children, should be considered in cases of persistent chest pain, and rapid diagnosis with contrast-enhanced tomography is vital

The first clinical case due to AP92 like strain of Crimean-Congo Hemorrhagic Fever virus and a field survey

<p>Abstract</p> <p>Background</p> <p>Crimean-Congo Hemorrhagic Fever (CCHF) is a fatal infection, but no clinical case due to AP92 strain was reported. We described the first clinical case due to AP92 like CCHFV.</p> <p>Methods</p> <p>A case infected by a AP92 like CCHFV was detected in Balkanian part of Turkey. Diagnosis was confirmed by RT-PCR and sequencing. A human serologic and tick survey studies were performed in the region, where the case detected.</p> <p>Results</p> <p>Thirty eight individuals out of 741 were found to be anti CCHFV IgM positive. The attack rate for overall CCHFV was calculated as 5.2%. In univariate analyses, CCHFV IgM positivity was found to be associated with the age (p < 0.001), male gender (p = 0.001), agricultural activity (p = 0.036), and history of tick bite (p = 0.014). In multivariate analysis, older age (OR: 1.03, CI:1.01–1.05, p < 0.001), male gender were found to be the risk factors (OR: 2.5, CI:1.15–5.63, p = 0.020) for CCHFV infection.</p> <p>Conclusion</p> <p>This is the first human case with AP92 like CCHFV infection. Furthermore, this is the first report of AP92 like strain in Turkey. In the region, elderly males carry the highest risk for CCHFV infection.</p

Evaluation of Serum D-dimer Levels in Children with Pneumonia

Aim: The aim of this study was to investigate the relationship of plasma D-dimer levels with duration of hospitalization and radiological and laboratory findings in patients with pneumonia. Methods: Forty-seven patients with pneumonia (31 boys and 16 girls, mean age: 4.2±4.7 years) were included in the study. The patients were divided into two groups according to duration of hospitalization and three groups according to radiological findings. D-dimer and other laboratory findings were compared between the groups. Results: The mean serum D-dimer level was 1333.5±1364.4 ng/L. There was no statistically significant difference in D-dimer, leukocyte, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) between the groups divided according to duration of hospitalization. In addition, there was no statistically difference in D-dimer levels between the groups divided according to radiological findings. Age, percentage of neutrophils, ESR and fibrinogen levels were higher in patients with lobar pneumonia when compared with the other groups and CRP level was higher in lobar pneumonia group when compared to interstitial pneumonia group. D-dimer levels were negatively correlated with age and positively correlated with ESR, CRP, and fibrinogen. Conclusion: In our study, D-dimer levels were high in patient with pneumonia. Further studies with a larger number of patients are necessary to determine the role of D-dimer levels as an acutephase reactant in patients with pneumoni