Serum Zinc in Patients with Protein-Energy Malnutrition Retrospective Assessment of Levels

Aim: This study aimed to investigate the frequency of serum zinc deficiency in children with PEM and to show the relationship between the degree of PEM and serum zinc level. Methods: Retrospective study conducted at Pediatric Gastroenterology, Hepatology, and Nutrition clinic, in a Selçuk University Hospital, 506 patients who aged between 1 and 18 years and diagnosed with PEM according to the Waterlow (YGB, BGA) classification were included in the study. Results: The prevalence of serum zinc deficiency in PEM patients was found to be 61.1%. The mean serum zinc levels of the patients in aged 1-5 founded significantly lower than the mean serum zinc levels of the patients in aged 5-12 and aged 12-18. There was no difference between PEM grades which calculated according to BGA and YGB criteria and serum zinc level averages. Although the relationship between the PEM grade calculated according to the BGA scale and the serum zinc level averages was not statistically significant degree, contrary to the increase in PEM grade, the mean decrease in serum zinc levels was noteworthy. Conclusion: It is important to measure serum zinc levels routinely in patients with PEM and to initiate zinc supplementation if deficiency is detected

Hematological Parameters and Inflammatory Markers in Children with Multisystem Inflammatory Syndrome

Abstract Objective: Multisystem inflammatory syndrome in children (MIS-C), is a newly recognised life-threatening complication of coronavirus disease 2019 (COVID-19). Early determination of clinical severity of the disease is important for early decision of treatment regimens. The aim of this study is to investigate the severity classification value of a number of hematological parameters, inflammatory markers and biochemical tests in patients with MIS-C during the acute stage and after anti-inflammatory treatment. Material and Methods: In this retrospective case-controlled study, 64 children with MIS-C and 95 healthy age and gender matched children were included. Patients were divided into three clinical severity groups; mild, moderate, and severe. Results: Mean platelet volume (MPV), MPV to lymphocyte ratio (MPVLR), D-dimer, ferritin, interleukin 6 (IL-6) levels were significantly higher, while albumin levels were lower in the severe MIS-C group compared to all the other groups on admission. Neutrophil-to-lymphocyte ratio (NLR) and derived (d) NLR (d-NLR) levels were significantly higher in the moderate group compared to the mild group. In the pre-treatment period of MIS-C patients had higher MPV, platelet distribution width (PDW) values while they had lower white blood cell, lymphocyte, monocyte, haemoglobin, mean corpuscular volume (MCV), red cell distribution width (RDW), plateletcrit and platelet values compared to the post-treatment group. Lymphocyte, platelets, and haemoglobin levels were significantly higher in the control group compared to the pre-treatment group. Acute phase reactants, NLR, NMR, PLR, d-NLR, MPVLR and systemic inflammatory index were significantly higher in all MIS-C patients on admission compared to the control group. Conclusion: Specific routine laboratory test results may be useful in determining disease severity of MIS-C, possibly predict the prognosis and allow early initiation of the appropriate treatment

Investigation of the Frequency of Viral Agents in Children with Acute Gastroenteritis in the 0-5 Years Age Group

Amaç: Viral gastroenteritler, çocukluk çağında görülen gastroenteritlerin en sık nedenidir. Başlıca enterik virüsler; rotavirüsler, enterik adenovirüsler, astrovirüsler, nörovirüsler ve sapovirüsleri içeren kalisivirüslerdir. Çeşitli ülkelerde yapılan son çalışmalarda nörovirüsler, çocukluk çağı gastroenteritlerinde önemli bir enterik patojen olarak belirlendi. Ancak nörovirüs enfeksiyonlarının epidemiyolojik özellikleri ve hastalık yükü bilinmemektedir. Çalışmanın amacı viral gastroenteritlerde nörovirüs sıklığını belirlemektir. Gereç ve Yöntemler: Kasım 2011-Aralık 2012 tarihleri arasında ishal atağı ile pediatri polikliniğine ayaktan başvuran 96 hastanın gaita örnekleri analiz edildi. Gaita örneklerinde, rotavirüs, enterik adenovirüs ve nörovirüs immünokromatografik yöntemle araştırıldı. Akut gastroenteritli 1-60 ay arası çocuklar çalışmaya dahil edildi. İshal atağının şiddeti 'Vesikari' skoru kullanılarak belirlendi. Bulgular: Hastalardan alınan 96 gaita örneğinin 53'ünde viral antijen tespit edildi. Rotavirüs %39.6, adenovirüs %10,4, nörovirüs %5.2, oranında tespit edildi. Hastaların ortalama yaşı 20,414,5 aydı. Çalışmada, gastroenteritle ilişkili semptomlardan kusma %77.1, ateş %50, karın ağrısı %24, bulantı %18.8 oranında bulundu. Kusma, rotavirüs pozitif hastalarda %92.1 oranında tespit edildi, istatiksel olarak anlamlı bulundu (p0.005).Sonuç: 0-5 yaş arası akut gastroenteritli çocuklarda 6 ay süren çalışmada, nörovirüsler; rotavirüs ve enterik adenovirüslerden sonra üçüncü viral patojen olarak saptanmıştır.Objective: Viral gastroenteritis is the most frequent cause of gastroenteritis in childhood. The major enteric viruses are rotaviruses, enteric adenoviruses, astroviruses and human caliciviruses including noroviruses and sapoviruses. Recent surveys conducted in various countries have identified noroviruses as an important enteric pathogens in sporadic cases of gastroenteritis in childhood. However, the epidemiological features and disease load are unknown. The aim of this study was to determine the incidence of norovirus gastroenteritis among viral gastroenteritis cases. Material and Methods: Stool specimens of 96 cases who had presented to our pediatrics outpatient clinic between November 2011 and April 2012 due to diarrhea were analyzed. Rotavirus, enteric adenovirus and norovirus were searched for in stool specimens using the immunochromatographic method. Patients with acute gastroenteritis between the ages of 1-60 months were included in the study. The severity of gastroenteritis was assessed by using the Vesicari scale. Results: Viral antigens were determined in 53 of the 96 stool specimens. Rotaviruses were identified in 39.6%, adenoviruses in 10.4%, and noroviruses in 5.2%. The mean age on admission was 20.414.5 months. The clinical symptoms associated with viral gastroenteritis in this study were vomiting (77.1%), fever (50%), abdominal cramps (24%), and nausea (18.8%). Vomiting was identified in 92.1% of rotavirus positive patients and this was statistically significant (p0.005). Conclusion: During the study period of six months, norovirus has determined as third viral pathogen after rotavirus and adenovirus with gastroenteritis in children 0-5 age group

Üniversite öğrencileri arasında bitkisel ilaç kullanımına yönelik tutumlar

Amaç: Bu çalışmada üniversite öğrencilerinin bitkisel ilaç kullanımı konusunda tutum ve davranışlarının saptanması amaçlanmıştır.Gereç ve Yöntem: Selçuk Üniversitesi’nde 2014 yılı Nisan-Haziran ayları arasında toplam 400 öğrenciye anket uygulandı. İstatistiksel analizlerde

Inherited Human ITK Deficiency Impairs IFN-γ Immunity and Underlies Tuberculosis

Inborn errors of IFN-γ immunity can underlie tuberculosis (TB). We report three patients from two kindreds without EBV viremia or disease but with severe TB and inherited complete ITK deficiency, a condition associated with severe EBV disease that renders immunological studies challenging. They have CD4+ αβ T lymphocytopenia with a concomitant expansion of CD4-CD8- double-negative (DN) αβ and Vδ2- γδ T lymphocytes, both displaying a unique CD38+CD45RA+T-bet+EOMES- phenotype. Itk-deficient mice recapitulated an expansion of the γδ T and DN αβ T lymphocyte populations in the thymus and spleen, respectively. Moreover, the patients\u27 T lymphocytes secrete small amounts of IFN-γ in response to TCR crosslinking, mitogens, or forced synapse formation with autologous B lymphocytes. Finally, the patients\u27 total lymphocytes secrete small amounts of IFN-γ, and CD4+, CD8+, DN αβ T, Vδ2+ γδ T, and MAIT cells display impaired IFN-γ production in response to BCG. Inherited ITK deficiency undermines the development and function of various IFN-γ-producing T cell subsets, thereby underlying TB

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Hepatit A Enfeksiyonu Olan Bir Çocuk Hastada Delta-Bilirubinemi ve İnatçı Kaşıntı

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