24 research outputs found

    Yenidoğan döneminde akut ürtiker ile prezente olan inek sütü proteini alerjisi

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    Urticaria is a common disease in children. But there are few case reportsin neonatal period. Urticaria has many causes, unfortunately it cannotbe figured out in some of the cases. Drug and food allergies, infectionsare common reasons that have been commonly shown. IgE-mediatedfood allergy should be considered in patients with acute urticaria and/orangioedema after food intake. Here we present a case of acute urticariadue to cow’s milk protein allergy in the newborn period. A 21-day-old malepatient was admitted to our emergency department with the complaintof widespread rash on the body which started one day earlier. Medicalhistory has revealed that he did not have a different drug intake beforethe onset of complaints, had no previous rashes, upper respiratory tractinfection or other infective-inflammatory disease since birth. His parentsdid not admit to another hospital. We obtained blood tests for food allergy.Total IgE: 38 IU/L and cow’s milk protein-specific IgE (f2): 2.26 kU/Lwere found to be suspicious for food allergy. According to these results,the formula which the baby was treated before has been stopped andextensively hydrolyzed formula has been started. After 12 hours, urticariahad started to fade. While going on our treatment, on 5th day the urticarialesions totally disappeared. Although urticaria is a common disease, it israrely reported in patients under six months. We want to emphasize thatfood allergies may be considered in cases presenting with urticaria inneonatal period.Ürtiker, küçük çocuklarda çok sık görülen medikal bir problemdir. Yenidoğan döneminde ise az sayıda olgu bildirimi vardır. Ürtikerin birçok olguda nedeni bulunamasa da oldukça fazla nedeni vardır. Daha çok gıda alerjisi, ilaç etkisi veya enfeksiyonlara bağlı meydana geldiği gösterilmiştir. Besin alımı sonrası akut ürtiker ve/veya anjioödem görülen hastalarda IgE aracılı besin alerjisinin olabileceği mutlaka akla getirilmelidir. Bu yazıda ise yenidoğan döneminde inek sütü proteini alerjisine bağlı gelişen akut ürtiker olgusı sunulmuştur. Yirmi bir günlük erkek hasta acil servisimize 1 gün önce başlayan vücuttaki yaygın döküntü şikayeti ile başvurdu. Hastanın öyküsünde şikayetleri başlamadan önce farklı bir ilaç alımı olmadığı, daha önce döküntülerinin olmadığı, doğumundan bu yana üst solunum yolu enfeksiyonu veya başka bir enfektif-enflamatuvar hastalık geçirmediği ve başka bir tıbbi kuruma başvurmadıkları öğrenildi. Hastanın besin alerjisi şüphesi açısından alınan tetkiklerinde Total IgE: 38 IU/L, süt spesifik IgE (f2): 2,26 kU/L olarak saptandı. Bu sonuçlara göre olgunun almış olduğu formüla mama kesilerek ileri derece hidrolize formüla başlanıldı. İzlemde olgunun 12 saat sonra vücuttaki döküntülü lezyonlar solmaya başladı ve tedavisinin 5. gününde tüm lezyonları düzeldi. Ürtiker, sık görülen bir hastalık olsa da 6 aydan küçük olgularda nadir olarak bildirilmektedir. Yenidoğan döneminde ürtiker tablosu ile başvuran olgularda besin alerjisi olabileceğinin akılda tutulması gerektiğini vurgulamak için olgumuz sunulmuştur

    Are Mean Platelet Volume and Neutrophil-to- Lymphocyte Ratio Valuable in The Early Detection of System Involvements in Henoch-Schönlein Purpura?

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    Aim:Henoch-Schönlein purpura (HSP) is the most common type of vasculitis in childhood, and severe complications due to intestinal and renal involvement can be observed. In this study, it was planned to investigate the value of mean platelet volume (MPV) and neutrophil-tolymphocyte ratio (NLR) in early detection of system involvement in HSP.Methods:A total of 119 patients diagnosed with HSP and 75 healthy controls were included in the study. Data on age, gender and physical examination as well as complete blood count, complete urine examination and faecal occult blood test were obtained from the files of the patients.Results:Gastrointestinal system (GIS) involvement was detected in 41 patients (34.45%), renal involvement in 35 patients (29.41%) and arthritis was detected in 21 patients (17.65%). It was determined that the mean hemoglobin (p=0.02) and MPV values (p=0.0001) o were significantly lower and the mean leukocyte (p=0.0001), platelet (p=0.0001), neutrophil (p=0.0001) count and NLR value (p=0.0001) were significantly higher in patients than in controls. No statistically significant difference was observed in the MPV and NLR values between patients with and without GIS involvement, renal involvement and arthritis.Conclusion:It is thought that MPV and NLR cannot be used as laboratory parameters in the early detection of system involvement in HSP

    The Assessment of the Neutrophil-lymphocyte Ratio and Platelet-lymphocyte Ratio in Dyslipidemic Obese Children

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    Objective:Childhood obesity is one of the most important children’s health problems that is gradually increasing all over the world. Dyslipidemia which coexists with obesity is a risk factor for atherosclerotic diseases in adulthood. In this study, the usability of the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in predicting dyslipidemia, a serious complication of obesity, in children were investigated.Method:Two hundred and seven cases aged between 11-17 years who were diagnosed with obesity at the Pediatrics Clinic of our hospital and 50 cases with no disorders whose complete blood count was performed for routine purposes were retrospectively investigated. The genders, ages, and examination findings of the cases were recorded. In obese children, leukocyte, hemoglobin, platelet, mean platelet volume, neutrophil and lymphocyte levels were evaluated in the complete blood count performed at the first admission. The NLR and the PLR were calculated. Preprandial blood glucose and preprandial insulin, serum aminotransferase values, and the lipid profile were recorded.Results:While dyslipidemia was determined in 99 (47.82%) of 207 cases who were diagnosed with obesity, it was not determined in 108 (52.18%) cases. The systolic blood pressure, diastolic blood pressure, and preprandial insulin level were higher in cases with dyslipidemia than the group without dyslipidemia. The PLR average of the dyslipidemic group was 112.75±39.11, the PLR average of the non-dyslipidemic group was 104.78±31.38, and the PLR average of the control group was 110.20±39.35, and there was no statistically significant difference between the PLR averages of the groups (p=0.353). The NLR average was 1.52±0.69 in the dyslipidemic group, 1.66±0.81 in the non-dyslipidemic group, and 1.72±1.26 in the control group. No statistically significant difference was observed between the NLR averages of all three groups (p=0.295).Conclusion:In this study, no relationship was determined between the PLR and NLR and dyslipidemia in obese children

    Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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    BACKGROUND: Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. METHODS: We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. FINDINGS: Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. INTERPRETATION: As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

    Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

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    BACKGROUND: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. METHODS: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING: Bill & Melinda Gates Foundation

    Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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    BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

    Comparison of the technical and economic performances of two different shredders on pomegranate pruning residues

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    Aim of study: The study aimed to examine the technical and economic performances of two different shredders for three windrow densities of pomegranate residues.Area of study: The study was conducted in the Serik District of Antalya Province, Turkey.Material and methods: Two different pruning residue shredders driven by tractor power take off (PTO) were used. Machine‑I has pick‑up, shredding, screen units. Machine‑II only has a shredding unit. The experiment was conducted at windrow densities of 1.49, 2.10, and 2.41 kg/m2 in a pomegranate orchard; the study used a completely randomized split‐plot design with two treatments and three replications.Main results: The power values for the increasing windrow densities were 8.00, 11.73, and 18.47 kW/m for Machine-I and 5.08, 5.68, and 6.48 kW/m for Machine-II. Moreover, the average particle length of 68.6 mm shredded by Machine‑I was approximately 20 mm smaller than that of Machine‑II. The minimum unit energy value of Machine-II was 2.53 kWh/t at the maximum windrow density of 2.41 kg/m2. This value for Machine-I was 5.58 kWh/t at the medium windrow density of 2.10 kg/m2. The lowest unit cost for Machine-I and Machine-II was calculated as 27.2-7.1 US/t(atmediumdensity)and16.83.5US/t (at medium density) and 16.8-3.5 US/t (at maximum density), respectively.Research highlights: The appropriate windrow densities for Machine-I and Machine-II were different in terms of energy requirements and total unit cost. Machine-I is more effective at consistently chopping the residues than Machine-II, but it requires more energy and a higher unit cost

    Empirical Modelling of Power Requirements in Olive Pruning Residue Shredding: Effects of Varying Moisture Content and Rotary Speeds

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    Pruning residues, which occur every year in orchards and have many different utilization potentials, are an important issue for fruit producers. The shredding process is indispensable and critical for the utilization of these residues. The performance of the shredding process is affected by the operating parameters of the shredding machine as well as the moisture content of the residues to be shredded. In this study, olive pruning residues with three different moisture contents were shredded at three different rotor speeds in the developed shredding system. We determined how the power requirement of the shredder changed under different conditions, and empirical models were developed. The experiments showed that the average power requirement of the shredder ranged from 7.32 to 10.81 kW, and it was found that residues with low moisture content decreased the power values, while higher rotor speeds increased the power requirement. The developed final model has a mean absolute error (MAE) of 0.376, a root mean square error (RMSE) of 0.441, and a correlation coefficient (R2) of 0.859. The model serves as a reliable tool for estimating power requirements in the shredding of olive pruning residues, enabling the selection of the optimal rotor speed based on moisture content
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