Typhoid Fever Complicated By Multiple Organ Involvement In A Child

A 12-year old girl was admitted to our clinic because of fever, headache, diarrhea and weakness for 10 days. Dyspne, tachycardia, hypotension, fever and letargy were determined in physical examination. The levels of urea, creatinine, aspartate aminotransferase, alanine aminotransferase were found to be increased. In echocardiography, myocardial dysfunction and low systolic functions were detected. Blood culture was positive for S.typhi. We report multiple organ involvement in a patient with typhoid fever and review the literature

EFFECTS OF ERYTHROPOIETIN ON THE SERUM AND LIVER TISSUE LEVELS OF COPPER AND ZINC IN RATS WITH OBSTRUCTIVE JAUNDICE EFEKTI ERITROPOETINA NA NIVOE BAKRA I CINKA U SERUMU I TKIVIMA JETRE KOD PACOVA SA OPSTRUKTIVNOM @UTICOM

Summary Background: Erythropoietin is an anti-apoptotic, anti-inflammatory, angiogenetic cytokine and has protective properties against oxidative stress. In this study we investigated the effects of erythropoietin on the le vels (serum and liver tissue) of copper and zinc in cholestatic rats. Methods: Thirty-two Wistar albino rats used in the study were divided into four groups -Group I: Sham; Group II: Erythropoietin; Group III: Obstruc tive Jaundice; Group IV: Obstructive Jaundice+Erythro poietin. After the first operation, rats were followed up for seven days and then operated for the second time. Rats were sacrificed by intracardiac blood taking, and the liver tissue samples were obtained immediately. Results: Erythropoietin reduces copper, and increases zinc levels in serum and liver tissues after obstructive jaundice (p<0.05). Furthermore, it has been shown that the levels of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, alkaline phosphatase and total bilirubin/direct bilirubin were significantly lower in Obstructive Jaundice+Erythropoietin group than Obstructive Jaundice group. Conclusions: Erythropoietin affects the changes in copper and zinc levels, thus decrea sing the liver damage biochemically in rats with obstructive jaundice. However, further investigations are needed to discover how erythropoietin therapy might reduce target organ damage in cholestatic liver cases by affecting copper and zinc levels

Urinary Tract Infections in Children

Urinary tract infections (UTI) are frequent conditions in children. Untreated urinary tract infections can lead to serious kidney problems that could threaten the life of the child. Therefore, early detection and treatment of urinary tract infection is important. In older children, urinary tract infections may cause obvious symptoms such as stomach ache and disuria. In infants and young children, UTIs may be harder to detect because of less specific symptoms. Recurrences are common in children with urinary abnormalities such as neurogenic bladder, vesicourethral reflux or those with very poor toilet and hygiene habits. This article reviews the diagnostic approach and presents the current data related to the roles of radiologic imaging, surgical correction and antibiotic prophylaxis of UTIs in children. [Archives Medical Review Journal 2009; 18(2.000): 57-69

Glucosamine-chondroitin sulphate accelerates tendon-to-bone healing in rabbits

Objectives: This study aims to investigate the contribution of glucosamine-chondroitin sulphate (GlcN-CS) to the healing of tendons within the bone tunnel. Materials and methods: Tendon-to-bone healing was investigated in 28 New Zealand rabbits by re-attaching the extensor digitorum longus tendon into bone tunnel which was created in the proximal tibia. Rabbits were separated into two groups as treatment and control groups. Treatment group (n=14) received 210-250 mg/kg/day glucosamine sulphate and 170-200 mg/kg/day chondroitin sulphate, whereas control group (n=14) received equivalent dose of vehicle. Treatment and control groups were compared at sixth and 12(th) week after the procedure according to histological and biomechanical analysis. Yamakado scoring system was used to evaluate the histological changes. Results: According to histological analysis, scores were significantly higher at both sixth and 12th week evaluations in the treatment group (p=0.029). Although not statistically significant, the ultimate pullout strength was higher in the treatment group at the 12(th) week evaluation (35.3 N /mm(2) vs. 24.3 N/mm(2)) (p>0.05). However, stripping occurred at the muscle-tendon junction in the treatment group whereas tendons stripped from the bone tunnels in the control group. While no tendons in the treatment group stripped from the bone tunnels, we observed at sixth and 12(th) week evaluations that tendons in the control group stripped from the tunnels. Conclusion: Glucosamine-chondroitin sulphate treatment enhances tendon-to-bone healing by increasing hyaline cartilage formation and decreasing formation of capillary vessels

Radiological and Functional Comparison of Single-Bundle Anterior Cruciate Ligament Reconstruction: Transtibial Versus Anteromedial Technique

Background/aim: This study aimed to compare radiological and functional outcomes of patients who had single-bundle anterior cruciate ligament (ACL) reconstruction with autologous hamstring tendon grafts using transtibial (TT) versus anteromedial (AM) femoral tunnel drilling techniques. Materials and methods: Sixty patients who had been operated on between 2010 and 2013 were enrolled in this study. Tunnel positions and widenings in the femur and tibia were evaluated with radiographs, arthrometric measurements with a Rolimeter arthrometer (Aircast, Summit, NJ, USA), stability assessment with Lachman and reverse pivot shift tests, and functional assessment with the International Knee Documentation Committee and Tegner and Lysholm scoring systems. Results: Tunnel enlargement in the sagittal and coronal planes of the femur was higher with the TT technique (P < 0.0001) and that of the coronal planes of the tibia was also higher with the TT technique (P = 0.01). During the assessment with the Rolimeter, the difference between sides was significant with the TT technique (P = 0.013). Positive results of the Lachman and reverse pivot shift tests were more frequent with the TT technique (P < 0.05), and the Lysholm scores were higher with the AM technique (P = 0.001). Conclusion: ACL reconstruction with hamstring autografts by either TT or AM technique demonstrated similar and excellent results in terms of functional outcomes at the end of the first postoperative year. The TT group had increased tunnel enlargement, which may have uncertain long-term outcomes, compared with the AM group.WoSScopu

P300 auditory event-related potentials in children with obesity: is childhood obesity related to impairment in cognitive functions?

Objective: To investigate alterations in P300 auditory event-related potentials in children with obesity to detect changes in cognitive functions

The phenotypic and molecular genetic spectrum of Alstrom syndrome in 44 Turkish kindreds and a literature review of Alstrom syndrome in Turkey

Alstrom syndrome (ALMS) is an autosomal recessive disease characterized by multiple organ involvement, including neurosensory vision and hearing loss, childhood obesity, diabetes mellitus, cardiomyopathy, hypogonadism, and pulmonary, hepatic, renal failure and systemic fibrosis. Alstrom Syndrome is caused by mutations in ALMS1, and ALMS1 protein is thought to have a role in microtubule organization, intraflagellar transport, endosome recycling and cell cycle regulation. Here, we report extensive phenotypic and genetic analysis of a large cohort of Turkish patients with ALMS. We evaluated 61 Turkish patients, including 11 previously reported, for both clinical spectrum and mutations in ALMS1. To reveal the molecular diagnosis of the patients, different approaches were used in combination, a cohort of patients were screened by the gene array to detect the common mutations in ALMS1 gene, then in patients having any of the common ALMS1 mutations were subjected to direct DNA sequencing or next-generation sequencing for the screening of mutations in all coding regions of the gene. In total, 20 distinct disease-causing nucleotide changes in ALMS1 have been identified, eight of which are novel, thereby increasing the reported ALMS1 mutations by 6% (8/120). Five disease-causing variants were identified in more than one kindred, but most of the alleles were unique to each single patient and identified only once (16/20). So far, 16 mutations identified were specific to the Turkish population, and four have also been reported in other ethnicities. In addition, 49 variants of uncertain pathogenicity were noted, and four of these were very rare and probably or likely deleterious according to in silico mutation prediction analyses. ALMS has a relatively high incidence in Turkey and the present study shows that the ALMS1 mutations are largely heterogeneous; thus, these data from a particular population may provide a unique source for the identification of additional mutations underlying Alstrom Syndrome and contribute to genotype-phenotype correlation studies