Comparison Of Two Cleaning Methods Intaking Urine Culture Samples In Children

Introduction: Urinary tract infection is one of the most prevalent bacterial infections among children. Difficulty in specimen collection and interpretation of improperly collected specimens may cause misdiagnosis of the urinary tract infection. In this study, it was aimed to compare the contamination ratio of urine specimens obtained after chlorhexidine or soap wipes cleaning. Materials and Methods: A total of 184 patients admitted to the hospital with the complaints like dysuria or urinary incontinence, hydronephrosis, horseshoe kidney, and recurrent urinary tract infection were included into the study. Patients were divided into two groups as specimens collected after cleaning with chlorhexidine (88) and soap wipes (96). Results: Escherichia coil was found as the most common pathogen in both groups. The ratio of contamination in urine culture for cleaning with chlorhexidine and soap were found as 21% and 29% respectively; hence, no significant difference in contamination rates was detected statistically (p= 0.3). The contamination ratio was found as 25.5% when both groups were evaluated together. Conclusion: Reducing contamination rate is vital regarding the repetition of tests, costs and time. Considering the fact that no significant difference in contamination rates was found in our study, both methods may be used in cleaning; however, since obtaining soap and water is cheaper and easier, we concluded that cleaning with soap wipes should be preferred.Wo

Home Accident Or Physical Abuse: Evaluation Of Younger Children Presenting With Trauma, Burn And Poisoning In The Pediatric Emergency Department

Most cases of physical abuse and neglect refer to pediatric emergency clinics, and these patients are diagnosed as only home accidents. Cases that cannot be diagnosed and managed correctly are again exposed to severe trauma and consequently, they may die. The aim of this study is to evaluate the physical abuse and neglect in children younger than three years of age, admitted to the pediatric emergency department with the complaints of trauma, burn, drug poisoning and/or caustic ingestion. This prospective study included 132 patients who were admitted to the pediatric emergency department. Children were classified into three groups as "no abuse", "suspected abuse" and "abused" after being evaluated with a standard form. Additionally, suspected abuse and abused cases were evaluated once again by "The Team of Child Abuse and Neglect Evaluation, Research and Treatment" in Hacettepe University, Ihsan Dogramaci Children's Hospital. The frequency of the suspected abuse or abused cases in all burn, trauma and poisoning cases was found to be 7.5%. It was noticed that 65 of the patients (49.2%) were physically neglected considering the mechanism of occurrence of events. Unplanned pregnancy, absence of prenatal follow-up, high number of siblings, previous physical abuse in the family, absence of witness during the event, and hospitalization were statistically significant differences between no abuse and suspected abuse or abused cases (p<0.05). Moreover, age group and income were significant risk factors in the logistic regression model for the patients who were thought to be suspected abuse/abused in univariate analyses (age group: Odds ratio (OR) 0.279, 95% confidence interval (CI) 0.085-0.723, p=0.0049; income: OR 2.323, 95% CI 1.052-6.198, p=0.0345). In conclusion, most cases of physical abuse and neglect are referred to the pediatric emergency clinics, and these patients are misdiagnosed as home accidents. The physicians working in the emergency department should be informed and trained in recognizing the cases of abuse and neglect, making the differential diagnosis, identifying the high-risk families and appropriate physical and psychological treatment for the abused and neglected children.WoSScopu

Febrile seizures in children with familial Mediterranean fever: Coincidence or association?

Background: Familial Mediterranean fever (FMF) is an inherited disease characterized by recurrent bouts of fever and polyserositis and caused by MEditerranean FeVer gene (MEFV) mutations. Given the febrile characteristics of the disease one would expect higher frequency of febrile seizure in this group of pediatric patients. Objectives: To evaluate the frequency of febrile seizure and related factors in patients with FMF

Changing trends in pediatric renal biopsies: analysis of pediatric renal biopsies in national nephrology registry data

Renal biopsy is the gold standard method for determining the diagnosis, treatment, and prognosis in children with renal disease. This study aims to evaluate the histopathological features of pediatric renal biopsies obtained from the national nephrology registry in the last two decades. Data recorded in the Turkish Society of Nephrology Registry System (TSNRS) in 1991 as well as in between 2001 and 2010 were analyzed. A total of 3892 biopsies were recorded; with the least number in 1991 (total 103 biopsies from 17 centers) and the highest number in 2008 (total 654 biopsies from 23 centers). Glomerular diseases constituted the main group in the registry (62.64\%), followed by systemic diseases (20.06\%). Focal and segmental glomerulosclerosis (FSGS) and Henoch-Schonlein purpura (HSP) nephritis (IgA vasculitis) were the most common glomerular and systemic diseases, respectively. Overall prevalence of renal amyloidosis and membranous nephropathy (MN) was quite low (1.87\% and 1.56\%, respectively) in all periods. Compared to 1991, there was an increasing trend in the frequencies of certain disorders including hemolytic uremic syndrome (HUS), IgA nephropathy, and HSP nephritis; and there was a decrease in acute proliferative glomerulonephritis (GN) in 2008. As well as demonstrating the etiologies of renal diseases which can only be identified by renal biopsies, this study provides important information regarding the changing patterns of histopathological findings due to better management of pediatric renal diseases over the years in Turkey

Cerebral Vasculitis in Henoch-Schönlein Purpura: A Case Report.

Henoch-Schönlein purpura is a common form of systemic small vessel vasculitis in childhood. Although headache and behavioral changes have been described in a significant proportion of children with Henoch-Schönlein purpura, severe neurological complications are rare. In this article, we report a case of central vasculitis in a four-year-old boy who presented with hemiplegia and aphasia. The treatment options for cerebral vasculitis of Henoch-Schönlein purpura are numerous but controversial in pediatric patients. Our patient was successfully treated by pulse methylprednisolone and pulse cyclophosphamide. The patient was followed-up for four years without any sequel

Successful treatment of a childhood synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome with subcutaneous methotrexate: A case report

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) is defined as a syndrome that is related to various osteoarticular manifestations and chronic dermatological conditions especially severe acne. SAPHO syndrome is a rare and unusual clinical entity in childhood and treatment choices are variable. We report an 11-year-old girl who suffered from SAPHO syndrome and successfully treated with subcutaneous methotrexate. We report our case in order to take attention to this rare clinical condition in evaluating patients and also to point out that treatment options beyond biologic agents should be the first line treatment in childhood

Molecular analysis of the AGXT gene in patients suspected with hyperoxaluria type 1 and three novel mutations from Turkey

Primary hyperoxaluria type 1 (PH1) is a rare, autosomal recessive disease, caused by the defect of AGXT gene encoding hepatic peroxisomal alanine glyoxylateaminotransferase (AGT). This enzyme is responsible for the conversion of glyoxylate to glycine. The diagnosis of PH1 should be suspected in infants and children with nephrocalcinosis or nephrolithiasis. Early diagnosis and treatment is crucial in preventing disease progression to end stage kidney disease (ESKD)

Results of native and transplant kidney biopsies of children in a single center over a 15 years period

Renal biopsy is an important diagnostic procedure in pediatric nephrology. This study retrospectively investigates the indications, results and complications in a single tertiary children's hospital in Turkey. We evaluated the native and transplant kidney biopsies in Gazi University Pediatric Nephrology Department between 2001 and 2015. A total of 196 biopsies (144 natives and 52 transplants) were included into the study. The mean age of the patients was respectively 10.8 +/- 3.5, 13.9 +/- 1.5years. The main indication for a biopsy was non-nephrotic proteinuria with or without hematuria (n=35), followed by steroid-resistance nephrotic syndrome (SRNS) (n=34) and Henoch-Schonlein purpura (HSP)-related proteinuria (n=20) for native kidneys. We found that focal segmental glomerulosclerosis (FSGS) (11.7\%) was the most common histopathologic diagnosis for native kidneys, but acute cellular rejection (7.6\%) was the most common histopathologic diagnosis for transplant kidneys. The complication rate in our study was founded 6.6\% totally. Different complication rates were found in other studies; however, we think that this difference comes from the inspecting methodology of the complications. Hence, we wanted to share our own experience in the context of other studies in the literature

Cerebral Vasculitis in Henoch-Schonlein Purpura: A Case Report

Henoch-Schonlein purpura is a common form of systemic small vessel vasculitis in childhood. Although headache and behavioral changes have been described in a significant proportion of children with Henoch-Schonlein purpura, severe neurological complications are rare. In this article, we report a case of central vasculitis in a four-year-old boy who presented with hemiplegia and aphasia. The treatment options for cerebral vasculitis of Henoch-Schonlein purpura are numerous but controversial in pediatric patients. Our patient was successfully treated by pulse methylprednisolone and pulse cyclophosphamide. The patient was followed-up for four years without any sequel