A Case With Short Stature, Growth Hormone Deficiency and 46, XX, Xq27-qter Deletion

We report a case of 11-year-old girl with growth retardation and 46, XX, Xq27-qter deletion. The endocrinologic evaluation revealed growth hormone deficiency. In karyotype analysis  46, XX, Xq27-qter deletion was determined. The deletion of terminal region of chromosome 27 is most commonly being detected during the evaluation of infertility, premature ovarian insufficiency or in screening for fragile X carrier status. To our knowledge, this is the first reported case with 46, XX, Xq27-qter deletion and growth hormone deficiency. Furthermore, this case might facilitate future search for candidate genes involved in growth hormone deficiency

A Rare Case of Cystinosis Presenting with Alkalosis

A 14-month-old girl was admitted to our clinic due to failure to thrive. Her weight and height were below the third percentile for age. Laboratory examination showed signs of alkalosis, hypokalemia, and hypochloremia. However, her urinalysis was consistent with renal tubular acidosis. Radiologic examination showed signs of active rickets. Based on clinical and laboratory findings, we focused on the probable diagnosis of cystinosis. Slit-lamp examination of the cornea confirmed our diagnosis. We should note that the presence of alkalosis does not exclude the possibility of diagnosis of cystinosis and we should be aware that if any slight doubt of cystinosis exists, patients should be carefully and completely evaluated for diagnosis

Understanding of Abdominal Compartment Syndrome among Turkish Pediatric Healthcare Providers: A Questionnaire Study

<p>Introduction: To establish the recognition and knowledge of intra-abdominal hypertension (IAH)/Abdominal Compartment Syndrome (ACS) among Turkish pediatric health care providers (PHCP). </p><p>Material Methods: A questionnaire was mailed to general pediatricians, pediatric intensivists and pediatric surgeons from different Turkish hospitals.</p><p>Results:</p><p>The response rate was 44.5%. Although 86.5% of participants have taken care of intensive care patient, only 34.3% had knowledge about ACS. 86.7% (13/15) of pediatric intensivists, 66.1% (37/56) of pediatric surgeons and 10.3% (11/107) of general pediatricians have had knowledge about ACS. Intra-vesical route was the most common method used to measure intra-abdominal pressure (IAP). Of the respondents, 44.4% measure IAP in patients expected to develop ACS.</p><p>Conclusions: Turkish PHCP are not familiar enough with ACS. Education is absolutely necessary for PHCP in Turkey to establish clear diagnostic criteria and appropriate management for this life-threatening condition.</p

Understanding of Abdominal Compartment Syndrome among Turkish Pediatric Healthcare Providers: A Questionnaire Study

<p>Introduction: To establish the recognition and knowledge of intra-abdominal hypertension (IAH)/Abdominal Compartment Syndrome (ACS) among Turkish pediatric health care providers (PHCP). </p><p>Material Methods: A questionnaire was mailed to general pediatricians, pediatric intensivists and pediatric surgeons from different Turkish hospitals.</p><p>Results:</p><p>The response rate was 44.5%. Although 86.5% of participants have taken care of intensive care patient, only 34.3% had knowledge about ACS. 86.7% (13/15) of pediatric intensivists, 66.1% (37/56) of pediatric surgeons and 10.3% (11/107) of general pediatricians have had knowledge about ACS. Intra-vesical route was the most common method used to measure intra-abdominal pressure (IAP). Of the respondents, 44.4% measure IAP in patients expected to develop ACS.</p><p>Conclusions: Turkish PHCP are not familiar enough with ACS. Education is absolutely necessary for PHCP in Turkey to establish clear diagnostic criteria and appropriate management for this life-threatening condition.</p

Alternative treatment applications in children with respiratory tract ınfections in the west of Turkey

Giriş: Toplumlar arası farklılıklar ve uygulamalar ne olursa olsun her geçen gün alternatif tedavilere eğilimin arttığı bilinmektedir. Bu çalışmada bölgemizde solunum yolu enfeksiyonu nedeniyle çocuklara uygulanan alternatif tedavilerin ve ailelerin bu tedaviler hakkındaki düşüncelerinin saptanması amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza Ekim 2011-Şubat 2012 tarihleri arasında Çanakkale Onsekiz Mart Üniversitesi Araştırma ve Uygulama Hastanesi Çocuk Sağlığı ve Hastalıkları Genel Polikliniğine; ateş, öksürük, boğaz ağrısı, hırıltı gibi şikâyetlerle başvurup üst veya alt solunum yolu enfeksiyonu tanısı alan 214 çocuk ve ebeveyni alındı. Bulgular: Ebeveynlerin %93,7’si değişen sıklıklarda ilaç dışı uygulamalardan faydalanmakta idi. Ailelerin alternatif uygulamaları %62,7 ilaç tedavisinden önce, %28,7 ilaçlarla birlikte, %6,7 ilaçlarla cevap alınamazsa, %1,9 hiç kullanmadıkları görüldü. En sık yapılan uygulamaların öksürüğü azaltmak için sade bal verilmesi (%30,6) ve ateşi düşürmek için ılık duş uygulaması (%48,1) olduğu belirlendi. Ailelerin bu uygulamalarla ilgili bilgi kaynakları %69,4 oranında akrabalar ve aile bireyleri idi. Alternatif tedavi uygulamaları ile ilgili bilgi alınmak istenen kaynak olarak ise %84,5 ile doktor ve hemşire gibi sağlık çalışanları gösterildi. Eğitim durumu ile ilaç dışı uygulama sıklığı arasında istatistiksel anlamlı ilişki saptandı. Ancak bilgi edinilmek istenen kaynak eğitim durumuna göre değişiklik göstermiyordu. Sonuç: Çocuk sağlığı ve hastalıkları hekimlerinin ve hemşirelerinin alternatif tedaviler hakkında bilgi edinip ailelere doğru yaklaşımlar hakkında yardımcı olmaları gerektiğini düşünüyoruz.Introduction: It is known that the trend toward alternative treatments is increasing each day regardless of the differences between communities. We aimed to detect alternative treatments in our region and to determine the thoughts of families about these treatments. Materials and Methods: A total of 214 patients presenting to General Pediatrics Outpatient Clinics of Çanakkale Onsekiz Mart University Teaching and Research Hospital between October 2012 and February 2012 with fever, coughs, sore throat, wheezing and diagnosed as upper or lower respiratory tract infection and their parents are included in the study. Results: A total of 93.7% of parents were using non-drug applications with varying frequencies. Alternative practices are being used prior to drug treatment (62.7%), with drugs (28.7%), when there is no response to drugs (6.7%) or never (1.9%). Most common used applications to reduce cough was to give pure honey (30.6%) and the most common application to lower the fever was to use warm shower (48.1%). Most common source of information for these applications was relatives and family members. It was shown that the most requested resources to get information were doctors, nurses and other health care professionals with 84.5%. There was statistically significant correlation between educational status and frequency of usage of non-drug applications. However, requested source of information did not change according to the educational status. Conclusions: As a result we thought that doctors and nurses dealing with child health and disease should obtain information about alternative treatments and help the parents about logical managements

Protective effect of glucagon-like peptide-2 in experimental corrosive esophagitis

Yildirim, Sule/0000-0002-1815-808XWOS: 000352501600010PubMed: 24641662Corrosive esophageal injuries are one of the life-threatening morbidities leading to esophageal stricture and perforation affecting all age groups but especially children due to accidental ingestions in this age group. Glucagon-like peptide-2 (GLP-2) is an intestinal polypeptide with potent anti-inflammatory effects. Its effects are studied in various studies but not in corrosive esophagitis. We aimed to investigate whether it has protective effect in experimental corrosive esophagitis, in the absence of existing studies into possible links. Twenty-four Wistar-albino rats, weighing 220-240 g, were randomized into three groups (n=8 in each). First group is control, second one is sham operated, and the third one is treatment group. Median laparotomy was made in all groups. In sham and treatment groups, esophagus was loosened and suspended from 1cm proximal to the esophageal junction. The esophagus segment between suspenders was exposed to 0.1mL 5% NaOH for 10 seconds. In the treatment group, rats were given GLP-2 for 7 days intraperitoneally. After 7 days, all rats were sacrified and esophagi were totally removed. In the histopathologic examination, esophageal tissues were compared in terms of inflammation, muscularis mucosa injury, and collagen deposition of tunica muscularis. Histopathologic changes in the esophageal tissues of groups were compared. Histopathologic injury in the GLP-2 treated group was significantly less than sham group (P<0.05). There was statistically significant healing in the GLP-2 treatment group. It is concluded that GLP-2 has a preventive effect on inflammation and collagen accumulation in an experimental corrosive esophagitis. In the light of the information that initial lesions in the early phase are predictors of complications, GLP-2 is a promising agent that has an anti-inflammatory effect in caustic injuries

Reply to: “Passive smoking increases pain perception in children during invasive medical procedures.”

AimTo establish whether there is any association between passive smoking and pain perception in children, in the absence of existing studies into possible links

Glucagon-like peptide-2 exhibits protective effect on hepatic ischemia-reperfusion injury in rats

Yildirim, Sule/0000-0002-1815-808XWOS: 000368445200012PubMed: 26290282Glucagon-like peptide-2 (GLP-2) has potent anti-inflammatory effects and protects against experimental ischemia/reperfusion (I/R) injury in pulmonary, intestinal, and myocardial tissue. However, its protective abilities against I/R injury in the liver are unknown. We investigated the potential role of GLP-2 pretreatment on hepatic I/R injury in rats. A total of 24 rats were randomly divided into three groups (n = 8). The first group was the control group; the second group was the vehicle-treated hepatic ischemia/reperfusion (HIR, vehicle saline-treated) group; and the third group was the GLP-2 pretreated I/R (GLP2-IR) group. Each rat in the third group was intraperitoneally administered 5 mu g GLP-2 for 5 d before the procedure. A portal triad was created to induce ischemia with a vascular atraumatic clamp. After 40 min, the clamp was released to initiate hepatic reperfusion for 6 h. Blood samples and tissue specimens from the liver were obtained. Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels significantly increased in the saline-treated HIR group (P < 0.001), whereas GLP-2 pretreatment significantly decreased their levels (P < 0.01). Our data suggested that GLP-2 pretreatment may have a protective effect on liver I/R injury. However, dose-response studies are necessary to determine the most effective dose

The comparison of parents perception on weight, appearance and appetite of their children with objective criteria

Amaç: Ebeveynlerin çoğunun çocuklarının vücut ağırlığı ya da iştahları ile ilgili endişelerinin olması çok yaygın bir durumdur. Hekimler ebeveynlerin çocukları hakkındaki yargılarına güvenmezler. Bu çalışmada ebeveynlerin, çocuklarının vücut ağırlığı ve görünümleri hakkındaki görsel algısı ile iştahları hakkındaki yargılarının, çocuklarının ve kendilerinin beden kitle indeksi (BKİ) gibi nesnel ölçütlerle karşılaştırmalı olarak incelenmesi amaçlanmıştır. Yöntem: Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Polikliniğine Ocak-Şubat 2012 tarihleri arasında herhangi bir yakınma ile başvuran, ortalama yaşları 6,42,8 (2-14 yaş arası) olan 150 çocuk ile anne veya babaları çalışmaya alındı. Ebeveyn ve çocukların BKİ değerleri ile çocukların yaşa göre BKİ persentilleri hesaplandı. Ebeveynlerden, çocuklarının iştahını nasıl değerlendirdikleri sorulup, çocuklarının görünümünü yaş grupları ve cinsiyete göre beden gelişimi için hazırlanmış zayıftan obeze değişen 7 setlik resimlerden uygun bulduklarıyla eşleştirmeleri istendi. Bulgular: Çocukların gerçek BKİ persentil aralıklarıyla karşılaştırıldığında, ebeveynlerin görseller üzerinden yaptığı eşleştirmelerde 55 (%36,7) çocuğun olduğundan daha zayıf değer- lendirildiği görüldü. İki değerlendirme arasındaki fark ebeveynlerin veya çocuğun cinsiyetine göre farklılık oluşturmuyordu ve çocuğun yaşı, ebeveyn eğitimi veya BKİ değeri ile korele değildi. Sonu ç: Ebeveynlerin çocuklarının vücut ağırlığı ve iştahı hakkındaki algıları ve değerlendirmeleri çocuğun durumunu nesnel olarak yansıtmamaktadır. Ebeveynlerle çocukların vücut ağırlığı ve iştahları hakkında konuşmak çocuk sağlığı danışmanlığının temel parçalarından biri haline getirilmelidir.Objective: Parental concerns about the development and appetite of their children a re common. Physicians do not trust the judgements of parents regarding their children. In this study, our aim was to assess parents visual perception of childrens body weight and appearance and judgement of their appetite. Then assessment results will be compared with objective criterion like body mass index (BMI) of both parents and their children. Methods: One hundred and ffty children with the average age of 6.4&plusmn;2.8 (2-14) years who attended to &Ccedil;anakkale Onsekiz Mart University Medical Faculty, Training and Research Hospital, Child Health and Disease Outpatient Clinics for any complaints during January and February 2012 were involved in the study. BMIs of both parents and children and BMI percentile of chil- dren for age were calculated. Parents were asked to evaluate appetite of their children and match the suitable appearance of their children with a previously constructed set of seven pictures, refecting physical develo pment adjusted for age and sex varying from lean to obese. Res ult: When we compared the real BMI percentiles of children with the visual assessm ents of parents, 55 (36.7%) of children were evaluated thinner than they were. The difference was not signifcant according to parents or gender of child and not correlated with the age of child, and education or BMI of parents. Con clusion: The perception of the parents related to their childrens physical development and appetite does not objectively refect the development of child. Talking to parents about body weight and appetite of children should be a fundamental component of child health counseling