Inferior vena cava indices determine volume load in minimal lesion nephrotic syndrome

The pathogenesis of edema in nephrotic syndrome has not been entirely understood. We investigated the value of the echographic parameters [inferior vena cava index (IVCI), inferior vena cava collapsibility index (IVCCI), and left atrium diameter (LAD)] to determine the volume load in children with minimal lesion nephrotic syndrome (MLNS). Twelve children with MLNS (seven boys, five girls) were included in this study. The patients were classified into three different stages (stage A: edematous; stage B: 50% decrease in weight gain; stage C: edema free) following measurement of their ideal weights. The ideal weight of patients in stage A was increased 13±7%. Serum total protein, albumin and urine sodium levels were found to be low in these patients. Plasma renin activity (PRA) and serum aldosterone levels in stage A were significantly different from those of the control group (P0.05). However, the increase in PRA was significant in stage C. Although a significant weight decrease was found in stages B and C, it had no effect on IVCI, LAD, and cardiothoracic index. We consider IVCI, IVCCI, and LAD measurements by echocardiography (ECHO) to be easy and reliable clinical methods for assessing the intravascular volume load in patients with MLNS

Clinical and radiological evaluation of five patients with double aortic arch [Çift arkus aorta: Beş vakanin klinik ve radyolojik degerlendirilmesi]

Double aortic arch is a very rare congenital vascular anomaly that causes tracheal and esophageal compression. In this study, clinical and radiological evaluations of five patients, four girls and one boy, diagnosed as double aortic arch between 1996-2002, were done. The average age was 7,2 months (4-11) and the average follow-up duration was 50 months. Four patients were admitted with the symptoms of respiratory distress, recurrent lung infection and feeding problems. One patient was asymptomatic. The patients were evaluated with plain chest X-ray, barium esophagogram, echocardiography, angiography and thorax magnetic resonance imaging. There was an accompanying congenital cardiopathy in two patients. Tetralogy of Fallot was seen in one patient, and PDA in the other. Surgical division of the left smaller arch was applied to the four patients. There was a complete recovery from the respiratory distress, cough and feeding problems in three patients. Although frequency and severity were decreased, expiratory wheezing continued in the patient with obliterative bronchiolitis

Hepatit B aşısından sonra ortaya çıkan sistemik romatoit artrit benzeri tablo gösteren bir olgu

Adverse effects of hepatitis B vaccine (mainly local reactions) are rare. Arthritis is one of the rarest complications. In this paper, complication of the vaccine mimicking rheumatoid arthritis in a 12-year-old boy is presented. The patient was admitted to hospital with the complaints of fever, ankles that had been painful for 10 days and rash that had started four days before admission. Physical examination revealed maculopapular rash involving the entire body, markedly increased on the proximal limbs and fading with press. Difficulty in walking due to painful ankles was noticed. No other problems were evident. Laboratory test results were nornmal except SGOT (50 IU/lt), SGPT (169 lU/lt ) and erythrocyte sedimantation rate (78 mm/h). Symptoms of fever and arthralgia disappeared with corticosteroid and acetyl salycylic acid treatment.Hepatit B aşılaması sonrasında yan etkiler ender olarak ortaya çıkmakta olup bunların en sık görüleni de aşı yerinde görülen lokal reaksiyonlardır. Çok daha ender olarak bildirilen komplikasyonlardan biri de artrittir. Burada aşılama sonrası komplikasyon gösteren 12 yaşında bir erkek olgu sunulmuştur. Fizik bakısında ekstremite proksimal kısımlarında belirgin olmak üzere, gövde ve yüzde basmakla solan, pembe kırmızı renkte döküntüler ve her iki ayak bileğindeki ağrı nedeniyle yürüme zorluğu vardı. Diğer sistem bakıları olağandı. Laboratuvar incelemelerinde; SGOT 50 Ü/lt, SGPT 169 Ü/lt, eritrosit sedimentasyon hızı 78 mm/saat bulundu; diğer test sonuçları normal bulundu. İzleminde ateş yüksekliği ve artraljisi kortikosteroit ve asetil salisilik asit uygulaması ile geriledi, döküntüler kayboldu

Percutaneous retrieval of a chronic catheter fragment from the left ventricle in a child

Embolization of a catheter fragment is a very rarely seen complication, and few cases have been reported in children. Catheter fragments must be urgently extracted due to life-threatening complications. Most catheter fragments are removed very soon after being lost in the cardiovascular system, including the venous system and right side of the heart. In our report, we describe a child with catheter fragment, which was removed from the left ventricle 32 days after embolization. This catheter fragment was successfully retrieved percutaneously using a gooseneck snare catheter through the femoral artery

Kalıcı pacemaker implantasyonu uygulanan pediatrik olgularımızın değerlendirilmesi

In this study, we evaluated 19 patients with permanent pacemaker. Eleven children were females, and 8 were males whose mean age was 9.8$pm$ 5.5 years at the time of implantation of pacemaker. Types of pacemaker were WIR in the 11 patients, DDDR in the 5 patients and ICD in the 3 patients. Indications for pacing were complete atrioventricular block in the 15 patients, sinus node arrest in the 1 patient, long QT syndrome in the 3 patients. In the ten patient, there was an underlying congenital heart disease. However heart disease was not found in the 9 patients. Mean follow-up period of the patients was 22.3 ;plusmn; 16.9 months. A neonate with complex congenital cardiopathy and complete atrioventricular block has died after epicardial pace implantation.Çalışmamızda kalıcı pacemaker implantasyonu uygulanan 19 olgu değerlendirildi. Vakalarımızın 11'i kız, 8'i erkek ve pacemaker implantasyon yaşı ortalama 9.8 ± 5.5 yıl idi. implante edilen pacemaker tipi 11 olguda WIR, 5 olguda DDDR ve 3 olguda ICD şeklindeydi. Pacemaker implantasyonu 15 olguda atriyoventriküler tam blok, 1 olguda sinusal arrest, 3 olguda ise uzun QT sendromu nedeniyle yapıldı. Dokuz olguda altta yatan bir kalp hastalığı saptanmazken, 10'unda kalp hastalığı mevcuttu. Olgularımızın ortalama izlem süresi 22.3 ± 16.9 ay idi. Kompleks konjenital kalp hastalığı saptanan ve atriyoventriküler tam blok nedeniyle cerrahi olarak epikardiyal pacemaker takılan 1 aylık bir olgu exitus ile sonuçlandı

ABDOMİNAL AORTA KATILIĞININ YAŞA BAĞLI DEĞİŞİMLERİ

Çocuklarda arteriyel sistemin pulsatil kompanentinin yaşa bağlı değişikliklerini gösteren son derecede az çalışma vardır