Mollaret meningitis: A case report

Mollaret meningitis is characterized by three or more episodes of benign recurrent aseptic meningitis in which symptoms and signs resolve spontaneously within two to five days. Severe headache with an acute onset, fever and meningismus are the main clinical features. We report a case of Mollaret meningitis in a seven-year-old girl who presented with four aseptic meningitis episodes in one year

Current treatment of acute bronchiolitis [Akut bronşiyolit tedavisinde yeni yaklaşimlar]

The most common lower repiratory tract infection in infants younger than two years is acute viral bronchiolitis that is leading cause of hospitalisation under six months of age. Little worldwide consensus exists about the best management strategies for this common disease are caring airway, maintenance of adequate hydration and oxygenation. Managements and the results in the use of bronchodilators, epinephrine and corticosteroids for bronchiolitis are conflicting. There is considerable controversy regarding its management in our country too. Here we review the treatment of acute bronchiolitis with the guidance of the recent literature

Effect of maternal smoking on colostrum and breast milk cytokines

Background: Breast milk contains several immune modulator components. The transfer of numerous cytokines via mother's milk may add to an active stimulation of the infant's immune system. There are many factors in breast milk that could either facilitate or inhibit cytokine activities. Smoking negatively influences the immune system and changes the concentrations of important cytokines. Objective: The objective of this study was to assess the effect of smoking during pregnancy on the cytokines found in colostrum and mature human milk. Methods: The study population included 25 smoker and 27 non-smoker nursing mothers who gave birth to a term healthy infant via cesarean section. Breast milk was collected from the mothers on the 2 nd -3 rd and 21 st -25 th days postpartum during visits to examine the newborns. Samples were analyzed for IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, TNF-? and TNF-ß cytokines by flow cytometric bead array. Results: We flrst saw that concentrations of IL-1 ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IFN-?, TNF-?, and TNF-ß cytokines, but not IL-12, were measurable both in colostrum and in mature milk, being higher in colostrum. Next we observed that IL-1ß and IL-8 levels were signiflcantly lower in colostrum, and IL-6 was found to be signiflcantly lower in the mature milk of smoking mothers. No signiflcant effects of maternal smoking on breast milk concentrations of IL-2, IL-4, IL-5, IL-10, IFN-?, TNF-?, and TNF-ß were observed. Conclusions: These flndings indicate that maternal smoking alters the colostrum and mature milk levels of some cytokines. Therefore, it is thought that active smoking during pregnancy decreases the concentration of certain cytokines in breast milk, which might account for the newborn's increased susceptibility to infections

Current management of acute bronchiolitis in Turkey [Türkiye'deki pediatristlerin akut bronşiyolite güncel yaklaşimlari]

Acute bronchiolitis is the most common lower respiratory tract infection in infants. The aim of this study was to overview the treatment practices of pediatricians in Turkey and to compare them with the current international management approaches. Questionnaires about acute bronchiolitis were distributed to pediatricians in the 49 th National Congress of Pediatrics and 2nd Congress of Pediatric Emergency and Intensive Care. The questionnare described a clinical scenario and this was followed by a list of management questions. Of a total of 300 questionnaires, 160 (53%) were returned. Of the participants, 88% give inhaled salbutamol, and 74% only oxygen or inhaled salbutamol plus oxygen in children with moderate acute bronhiolitis. Pediatricians in state hospitals use steroid (42%) and cold mist therapy (10%) more than in university and training hospitals (p<0.05). Epinephrine administration was significantly lower than in state hospitals and university and training hospitals, respectively at 2% and 5%. The most common survey in acute bronchiolitis was chest radiographs (68%). Antibiotics were prescribed routinely by 10% of state hospital pediatricians and by 6% of university and training hospital pediatricians. In conclusion, in light of the new, randomized, controlled clinical research and meta-analyses, guidelines have to be updated and continuous education provided with evidence-based protocols

Late Presenting Congenital Diaphragmatic Hernia as Tension Gastrothorax

[No abstract available

Assessment of the clinical and radiological findings of cases with subacute sclerosing panencephalitis [Subakut Sklerozan Panensefalit'li Olgulari{dotless}mi{dotless}zi{dotless}n Klinik ve Radyolojik Bulgulari{dotless}ni{dotless}n Degerlendirilmesi]

Aim: Subacute sclerosing panencephalitis (SSPE) is a slow virus infection, arising in the central nervous system in the form of late complication of measles virus. In this study we aimed to research the clinical and radiological features of our patients with SSPE. Material and Method: The study was attended by 19 patients with SSPE being followed-up in the Child Neurology Clinic of the Medical Faculty of Harran University. Patients were assessed as per the following aspects, including age, gender, measles case, complaints resulting in the application, findings from clinical phase and magnetic resonance imaging (MRI) of brain. Results: While 68.4% (n = 13) of the patients were male, remaining 31.6% (n = 6) thereof were female. At the time of application, atonic and myoclonus seizures were seen among 31.5% (n = 6) of the patients, and mental and behavioral changes were seen among 20% (n = 4) thereof. In MRI of brain, involvement was seen the most in cortical, sub-cortical, and periventricular white matter fields. Among the findings from MRI of brain, those detected as normal were 36.8% (n = 7) of the total. Discussion: At places where SSPE is seen as endemic, presence of such psychological findings among children, including atonic and myoclonic seizures, personality changes, aggressive behaviors, or autism, should be considered as a warning. Meanwhile, it should further be considered that, MRI of the brain at the earlier stages of the disease may bring forth normal findings in high ratios

Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child

Theophylline poisoning generally occurs due to acute high dose intake as well as chronic intake of the medication. Toxicity symptoms can be seen with a plasma concentration of theophylline over 20 µg/ml. The consequences of theophylline toxicity include metabolic disturbances (hypokalemia, hyperglycemia, and metabolic acidosis), nausea, vomiting, and in severe cases seizures, cardiac arrhythmias, and death. Theophylline poisoning in children is rarely described in the literature. A 3-year-old girl was referred from another hospital to our pediatric intensive care unit (PICU) due to prolonged refractory status epilepticus and respiratory failure linked with severe theophylline poisoning. The patient was admitted to our PICU 24 hours after the patient took theophylline. The referring center could not measure the serum theophylline level. The patient’s first serum theophylline level that was checked at admission was 54 µg/ml. We started continuous venovenous hemodialysis (CVVHD) 3 hours after PICU admission and the patient’s theophylline level successfully decreased within 9 hours. The patient was discharged at the 40th day of admission from our hospital with severe neurological disability. In conclusion, severe theophylline poisoning may be seen in children. We must consider CVVHD in critically ill children with severe theophylline poisoning. © 2016, Turkish Journal of Pediatrics. All rights reserved