Çocukluk çağında periferik lenfadenopatiler: tek merkezli çalışma

Purpose: Lymphadenopathy is defined as an abnormality in the size and/or character of lymph node. In this study we aimed to describe the clinical and laboratory findings of benign and malignant causes of peripheral lymphadenopathy in childhood. Material and Methods: Two hundred and twenty four patients who were admitted to the clinic with peripheral LAP were evaluated. Age, gender, laboratory and radiologic findings, final diagnoses, and duration, localization, size, consistency, spread, and accompanying local and systemic symptoms of LAP were determined. Benign and malignant causes of peripheral lymphadenopathy were compared. Results: One hundred twenty-six patients (56.0%) were male and 98 patients (44.0%) were female. After the first evaluation the patients were divided into two groups. The first group included 186 patients with benign causes and the second group included 38 patients with malignant causes. One hundred and sixty four of 224 patients (73.2 %) had localized peripheral lymphadenopathy. The most frequent cause of localized lymphadenopathy in the benign group was acute lymphadenitis (34.8%). The most common cause of localized lymphadenopathy in the malignant group was Hodgkin's lymphoma (4.3%). Sixty of 224 (26.8%) patients had generalized peripheral lymphadenopathy. The most significant cause of generalized lymphadenopathy in the benign lymphadenopathy group was Epstein-Barr virus (10.0%), whereas Hodgkin's lymphoma (23.3%) was the most common cause in malign lymphadenopathy group. Localized and generalized lymph node enlargement was most frequently found in cervical region. The most frequent site of involvement among benign and malignant cases was the cervical area. The results revealed that findings such as chronic course, generalized LAP, supraclavicular, cervical and inguinal location, organomegaly, hilier LAP, abdominal LAP, and abnormal laboratory findings (thrombocytopenia and blasts on the peripheral blood smear) were associated with malignant diseases. Conclusion: Infections are the most common cause of peripheral LAP. The risk of malignany increases with the age of child and the duration of LAP. Older children with chronic LAP, generalized LAP associated with organomegaly, abnormal laboratory findings should be considered as malignant LAP.Amaç: Lenfadenopati, lenf nodunun boyut ve/veya karakterindeki anormallik olarak tanımlanır. Bu çalışmada amacımız çocukluk çağında selim ve malign nedenlere bağlı periferik lenfadenopatilerin klinik ve laboratuvar bulgularını belirlemek. Materyal ve Metod: Çalışmaya periferik lenfadenopati nedeni ile hastanemize başvuran 224 hasta alındı. Hastaların; yaşı, cinsiyeti, laboratuvar ve radyolojik bulguları, tanıları, lenfadenopatinin; süresi, lokalizasyonu, boyutu, kıvamı, yayılımı, eşlik eden lokal ve sistemik semptomları kaydedildi. Malign ve selim hastalıklara bağlı lenfadenopatilerin klinik ve laboratuvar özellikleri karşılaştırıldı. Bulgular: İki yüz yirmi dört hastanın 126’sı (%56.0) erkek, 98’i (%44.0) kız idi. Hastalar 2 gruba ayrıldı. Birinci grupta selim nedenlere bağlı lenfadenopatisi olan 186 hasta, ikinci grupta ise malign nedenlere bağlı lenfadenopatisi olan 38 hasta mevcuttu. Yüz altmış hastada(%73.2) localize lenfadenopati vardı. Selim hasta grubunda lokalize lenfadenopatinin en sık nedeni akut lenfadenitler (%34.8) iken, malign hasta grubunda en sık nedenin Hodgkin lenfoma (%4.3) olduğu tespit edildi. İki yüz yirmi dört hastanın 60’ında (%26.8) jeneralize lenfadenopati vardı. Jeneralize lenfadenopatinin selim hasta grubunda başlıca nedeni Epstein–Barr virus enfeksiyonu (%10.0) iken, malign hasta grubunda Hodgkin lenfoma (%23.3) olduğu tespit edildi. Servikal bölge lokalize ve jeneralize lenfadenopatilerde en sık tutulan bölgedir. Malign ve selim nedenlere bağlı lenfadenopailer en sık servikal bölgede görüldü. Elde ettiğimiz sonuçlara göre kronik seyirli, jeneralize lenfadenopati, supraklavikular, servikal ve inguinal yerleşimli lenfadenopati, organomegali, abdomanial lenfadenopati, hilier lenfadenopati ve anormal laboratuvar bulgularının (trombositopeni, periferik yaymada blast ) varlığında öncelikle malign nedenler düşünülmelidir. Sonuç: Enfeksiyonlar çocukluk çağında periferik lenfadenopatinin en sık nedenidir. Malignite riski yaş ve lenfadenopatinin süresi ile artmaktadır. İleri yaş, kronik lenfadenopati, jeneralize lenfadenopati, eşlik eden organomegali, anormal laboratuvar bulguların varlığında öncelikle malignite düşünülmelidir

Protein Z G79A polymorphism in patients with severe sepsis

The aim of the study is to investigate whether the presence of a protein Z polymorphism is a risk factor for the development and outcome of sepsis. Sepsis is a clinical syndrome characterized by the presence of systemic signs and symptoms of inflammation. When sepsis leads to organ failure, the term severe sepsis and septic shock is used. The genetic causes of severe sepsis are not fully explained. Protein Z is a vitamin K– dependent glycoprotein and a member of the coagulation cascade. The study included 53 patients with severe sepsis and 70 control healthy volunteers without a familial history of thrombosis. The G79A polymorphism of intron F of the protein Z gene was analyzed by the method of polymerase chain reaction–based DNA analysis. The protein Z intron F G79A polymorphism frequencies of the patients and controls were 43.4% and 40%, respectively. Carrying 79 AA genotype could be a risk factor for severe sepsis and septic shock (OR ¼ 4.5, 95% CI: 0.45-46.1), but it could not find any difference between survivor and nonsurvivor groups. They concluded that the frequency of intron F G79A polymorphism of protein Z gene was higher in patients than controls, and carrying 79 AA genotype could be a risk factor for severe sepsis and septic shock

A rare cause of acute abdominal pain in adolescence: hydrosalpinx leading to isolated torsion of fallopian tube

Torsion of the fallopian tube accompanying hydrosalpinx is a rare occurrence in the pediatric population. This report describes a 13 year old sexually inactive girl with isolated tubal torsion due to hydrosalpinx. The girl had lower left abdominal pain for two days. The physical examination revealed left lower quadrant tenderness with a firm round anterior mass on rectal examination. Abdominal ultrasound showed left tubal enlargement with free pelvic peritoneal fluid. Magnetic Resonance Imaging (MRI) showed engorgement and dilatation of the left fallopian tube without contrast enhancement suspicious of tubal torsion. At operation, torsion of the left tube on its longitudinal axis was observed, and a salpingectomy was performed. Although rare, the diagnosis of torsion of the fallopian tube should be considered when evaluating acute abdominal pain. The earlier tubal torsion is diagnosed, the greater the likelihood of salvaging the fallopian tube. (C) 2012 Elsevier Inc. All rights reserved

The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

Opisthotonos: a newly recognized side effect of midazolam

A 13-month-old boy was admitted to our hospital for investigation of recurrent respiratory symptoms. He had no history of seizure disorder. His laboratory tests were normal. He was taking ampicillin-sulbactam. In order to explain his symptoms, computed tomography (CT) of the chest was planned and midazolam 0.1 mg/kg was administered intranasally to sedate the patient before obtaining CT. However, the patient developed an opisthotonic posture soon after midazolam administration. It lasted 10 minutes and subsided spontaneously

Peripheral Lymphadenopathy in Childhood: Single Center Study

Purpose: Lymphadenopathy is defined as an abnormality in the size and/or character of lymph node. In this study we aimed to describe the clinical and laboratory findings of benign and malignant causes of peripheral lymphadenopathy in childhood. Material and Methods: Two hundred and twenty four patients who were admitted to the clinic with peripheral LAP were evaluated. Age, gender, laboratory and radiologic findings, final diagnoses, and duration, localization, size, consistency, spread, and accompanying local and systemic symptoms of LAP were determined. Benign and malignant causes of peripheral lymphadenopathy were compared. Results: One hundred twenty-six patients (56.0%) were male and 98 patients (44.0%) were female. After the first evaluation the patients were divided into two groups. The first group included 186 patients with benign causes and the second group included 38 patients with malignant causes. One hundred and sixty four of 224 patients (73.2 %) had localized peripheral lymphadenopathy. The most frequent cause of localized lymphadenopathy in the benign group was acute lymphadenitis (34.8%). The most common cause of localized lymphadenopathy in the malignant group was Hodgkin's lymphoma (4.3%). Sixty of 224 (26.8%) patients had generalized peripheral lymphadenopathy. The most significant cause of generalized lymphadenopathy in the benign lymphadenopathy group was Epstein-Barr virus (10.0%), whereas Hodgkin's lymphoma (23.3%) was the most common cause in malign lymphadenopathy group. Localized and generalized lymph node enlargement was most frequently found in cervical region. The most frequent site of involvement among benign and malignant cases was the cervical area. The results revealed that findings such as chronic course, generalized LAP, supraclavicular, cervical and inguinal location, organomegaly, hilier LAP, abdominal LAP, and abnormal laboratory findings (thrombocytopenia and blasts on the peripheral blood smear) were associated with malignant diseases. Conclusion: Infections are the most common cause of peripheral LAP. The risk of malignany increases with the age of child and the duration of LAP. Older children with chronic LAP, generalized LAP associated with organomegaly, abnormal laboratory findings should be considered as malignant LAP

Citation Analysis of National Medical Journals Published in Infectious Diseases and Clinical Microbiology Field

In this study our aim was to perform citation analysis of journals published in infectious diseases and clinical microbiology field in Turkey. Selected journals were Turkish Journal of Infection, KL‹M‹K Journal, ANKEM Journal, Viral Hepatitis Journal, Turkish Journal of Hospital Infections, Turkish Microbiology Association Journal, Microbiology Bulletin and Flora Journal. Citation data was retrieved by searching Science Citation Index Expanded. When we analysed overall citation data between January 1994 and May 2004, the most cited three journals were Microbiology Bulletin (191), Turkish Journal of Infection (121) and Turkish Microbiology Association Journal (44). In 2003, journals with an impact factor greater than 0 were Turkish Journal of Infection (0.011), ANKEM Journal (0.008) and Viral Hepatitis Journal (0.007). None of the journals had an immediacy index greater than 0 in 2003. As a result, total number of citations, impact factors and immediacy index of analysed journals were not high but the progress in recent years gives hope for the future

Acute tumor lysis syndrome secondary to a single-dose methylprednisolone in acute lymphoblastic leukemia

[No Abstract Available

Pooled analysis of 899 nosocomial meningitis episodes from Turkey

WOS: 000395632600004PubMed ID: 28263502Background/aim: Healthcare-associated meningitis (HCAM) is a relatively rare entity with significant morbidity and mortality. The aim of this study was to systematically review the Turkish medical literature for acute nosocomial meningitis. Materials and methods: One national (ULAKBIM) and two international (www. scopus. com and www. pubmed. com) databases were searched. In addition, abstracts of four national congresses held between 2004 and 2013 were searched for reports for HCAM meningitis. Results: Data for 899 HCAM meningitis episodes were obtained from 24 reports. In terms of clinical findings, 177 of 216 (81.9%) had fever (> 38 degrees C), 55 of 64 (85.9%) had high CRP levels, 105 of 132 had leukocytosis (> 10,000/mm3), and 241 of 759 had shunt infection. Cerebrospinal fluid culture yielded a pathogen in 689 of 872 nosocomial meningitis episodes. The most common pathogen was Acinetobacter spp. (30.7%), followed by coagulase-negative staphylococci (21.2%) and Staphylococcus aureus (19%). Carbapenem resistance was reported in 18 of 48 (37.5%) Acinetobacter spp. Overall mortality was 160/593 (27%). Pathogen-specific mortality was 55.5% (30/54) for A. baumannii whereas it was 18.9% (7/37) for S. aureus and 2/17 (11,7%) for MRSA. Conclusion: Nosocomial meningitis is still a serious and highly fatal disease. More preventive measures should be sought to further decrease HCAM meningitis and the mortality/morbidity related to it