Serum procalcitonin and cerebrospinal fluid cytokines level in children with meningitis.

AIMS: To determine the level of serum procalcitonin and cerebrospinal fluid cytokines in children with bacterial or viral meningitis and to document the use of these parameters in differential diagnosis. RESULTS: Before the start of antibiotic treatment, serum procalcitonin and tumor necrosis factor alpha levels were found to be higher in acute bacterial meningitis compared with viral meningitis and with the control group. Similarly, cerebrospinal fluid interleukin-6 levels were found to be significantly higher in children with acute bacterial meningitis compared with viral meningitis. However, no significant difference was determined between groups in respect to the cerebrospinal fluid interleukin-8 level. CONCLUSION: Serum procalcitonin and cerebrospinal fluid tumor necrosis factor alpha levels can be used in the early diagnosis of bacterial meningitis. Similarly, they may be useful adjuncts in differential diagnosis of bacterial and viral meningitis

Design of Feedforward Neural Networks in the Classification of Hyperspectral Imagery Using Superstructural Optimization

Artificial Neural Networks (ANNs) have been used in a wide range of applications for complex datasets with their flexible mathematical architecture. The flexibility is favored by the introduction of a higher number of connections and variables, in general. However, over-parameterization of the ANN equations and the existence of redundant input variables usually result in poor test performance. This paper proposes a superstructure-based mixed-integer nonlinear programming method for optimal structural design including neuron number selection, pruning, and input selection for multilayer perceptron (MLP) ANNs. In addition, this method uses statistical measures such as the parameter covariance matrix in order to increase the test performance while permitting reduced training performance. The suggested approach was implemented on two public hyperspectral datasets (with 10% and 50% sampling ratios), namely Indian Pines and Pavia University, for the classification problem. The test results revealed promising performances compared to the standard fully connected neural networks in terms of the estimated overall and individual class accuracies. With the application of the proposed superstructural optimization, fully connected networks were pruned by over 60% in terms of the total number of connections, resulting in an increase of 4% for the 10% sampling ratio and a 1% decrease for the 50% sampling ratio. Moreover, over 20% of the spectral bands in the Indian Pines data and 30% in the Pavia University data were found statistically insignificant, and they were thus removed from the MLP networks. As a result, the proposed method was found effective in optimizing the architectural design with high generalization capabilities, particularly for fewer numbers of samples. The analysis of the eliminated spectral bands revealed that the proposed algorithm mostly removed the bands adjacent to the pre-eliminated noisy bands and highly correlated bands carrying similar information

Migration of a Broken Kirschner Wire after Surgical Treatment of Acromioclavicular Joint Dislocation

Kirschner wire (K-wire) is one of the commonly used implants in orthopaedics practice. Migration of the wire is one of the most frequently reported complications after fixation by the K-wire. In particular, it has been reported that a greater range of motion in the shoulder, negative intrathoracic pressure associated with respiration, gravitational force, and muscular activities may cause migration from the upper extremities. In general, thin and long foreign bodies with smooth surfaces that are localized within the tendon sheath and at an upper extremity can migrate more readily and can reach longer distances. Here, we present a patient with long-term migration of a broken K-wire who underwent fixation for acromioclavicular joint dislocation 5 years ago

Total hip arthroplasty in the developmental dysplasia of the hip using transverse subtrochanteric osteotomy

BACKGROUND: We assessed the results of the transverse subtrochanteric femoral shortening osteotomy technique and the cementless THA process applied to Crowe type III and IV patients with developmental dysplasia of the hips. METHODS: We retrospectively evaluated 25 patients (32 hips) between 2006 and 2014. RESULTS: The mean follow-up time was 5.1 years. The mean preoperative Harris hip score was 49.5, which increased to 87.1 postoperatively. The mean preoperative leg-length discrepancy was 3.6 cm; the mean postoperative discrepancy was 0.5 cm. CONCLUSION: THA with subtrochanteric femoral shortening osteotomy technique is an effective technique for treating developmental dysplasia of the hip

Acute peritoneal dialysis in neonatal intensive care unit: An 8-year experience of a referral hospital

Background: The aim of present study was to evaluate the indications, complications and outcomes of acute peritoneal dialysis (APD) in neonates at a referral university hospital during the previous 8 years. Methods: This retrospective analysis included a total of 52 newborn infants who underwent APD in a neonatal intensive care unit between January 2008 and March 2016. Demographic, clinical, laboratory and microbiological data were extracted from patients' medical files. Results: The primary causes for requiring APD were acute tubular necrosis (n = 36, 69.2%), inborn error of metabolism (n = 10, 19.2%), congenital nephrotic syndrome (n = 2, 3.9%), bilateral polycystic kidney (n = 2, 3.9%), renal agenesis (n = 1, 1.9%), and obstructive uropathy (n = 1, 1.9%). The mean duration of APD was 8.7 ± 15.87 days (range: 1–90 days). Procedural complications were mainly hyperglycemia (n = 16, 47.1%), dialysate leakage (n = 7, 20.6%), peritonitis (n = 3, 8.8%), catheter obstruction (n = 3, 8.8%), bleeding at the time of catheter insertion (n = 2, 5.9%), catheter exit site infection (n = 2, 5.9%), and bowel perforation (n = 1 2.9%). There were 40 deaths (76.9%), mainly due to underlying causes. Ten of the 12 survivors showed full renal recovery, but mild chronic renal failure (n = 1) and proteinuria with hypertension were seen (n = 1) in each of remaining patients. Conclusion: Peritoneal dialysis is an effective route of renal replacement therapy in the neonatal period for management of metabolic disturbances as well as renal failure. Although major complications of the procedure are uncommon, these patients still have a high mortality rate due to serious nature of the underlying primary causes. Key Words: acute peritoneal dialysis, complication, mortality, neonatal intensive care unit, newbor