Higher frequency of methicillin resistant bacteria in children with familial mediterranean fever

To investigate resistant microorganisms in nasal mucosa of children with Familial Mediterranean Fever. The study was conducted from March to May 2013 at Mustafa Kemal University, Turkey, and comprised children with Familial Mediterranean Fever and healthy controls. All subjects had no history of antibiotic or local and/or systemic steroid use within the preceding 2 weeks. Nasal swab samples were obtained from all the subjects. Strain identification was done by using standard methods. SPSS 13 was used for statistical analysis. Of the 151 subjects in the study, 73[48.34%] were cases and 78[51.65%] were controls. Among the cases, there were 26[35.6%] girls, while among the controls, there were 40[51.3%] girls [p=0.052]. The mean age of the cases was 7.78 +/- 3.34 years [range: 3-15 years], while it was 8.15 +/- 2.71 years [range: 3-16] among the controls [p=0.208]. Methicillin-resistant coagulase-negative staphylococcus and methicillin-resistant staphylococcus aureus were isolated in both the groups. The growth rate of resistant bacteria was 63% [n=46] in the cases, in the controls [p=0.003; odds ratio [OR]: 2.7; 95% confidence interval [CI]: 1.4-5.2]. Among the controls, history of hospitalisation increased the risk for the presence of resistant bacteria by 7.7 fold [OR: 7.7; 95% CI: 1.4 - 40.4]. Higher rates of resistant bacteria showed that they were at risk of comorbidities related to antibiotic resistance

incidence of preeclampsia in Intra-Cytoplasmic Sperm Injection pregnancies

We aimed to evaluate the association between infertility etiology in Intra-Cytoplasmic Sperm Injection [ICSI] pregnancies and preeclampsia; besides, we aimed to discuss the effect of the paternal factor in the pathogenesis of preeclampsia. We hypothesized that preeclampsia is more common in ICSI pregnancies with male factor. It is known that maternal exposure to paternal sperm cells over a time period has a protective effect against preeclampsia. Male partners with azospermia have no sperm cells in their seminal fluid, whose female partners will not be able to develop some protective immunity against preeclampsia. We hypothesized that the infertile couples with male factor [partner with azoospermia and also oligospermia] would be an ideal model to test the partner-specific protective immunity against preeclampsia, as the women had no chance to develop adequate protective immunity via the partner's sperm exposure. This Single-center, retrospective study included 508 infertile couples admitted to our IVF center between January 2001 and March 2008. The data regarding the maternal age, etiology of the infertility, the pregnancy rates, abortus ratio and viable pregnancy rates was collected from the case files. Antenatal complications such as preeclampsia, placenta previa, abruptio placenta, premature rupture of membranes, premature labor, oligohydramnios, gestational diabetes, postmaturity, postpartum complications and neonatal outcomes were evaluated via the file records and phone interviewing. The study population was divided into two main groups according to the etiology of infertility. 301 of the study population [group 1] was infertile due to male factor and 207 of the study population [group 2] was female factor and unexplained infertility cases.Group 1 patients were divided further into two subgroups: group 1a included 56 cases in which TESE [testicular sperm extraction] was used to obtain the sperm cells as the male factor was severe and as there was no sperm cells in seminal fluid. Group 1 b consists of 245oligospermic cases who obtained sperm cells via conventional methods. The mean ages of women in Group one and two were 30.22 +/- 5.06 and 31.58 +/- 4.36 years respectively [p=0.001]. 129 cases [42,8%] from group one and 106 cases [51,2%] from Group two ended in first trimester and early second trimester [<24 gestational weeks] pregnancy loss. In group one, only 172 cases of 301 pregnancies passed over 24 weeks of gestational age, whereas in group two, 101 cases of 207 patients passed over 24 gestational weeks. There was no significant difference between two groups regarding chemical pregnancies and early pregnancy loss [p=0.314]. There was no significant difference between the groups regarding placenta previa, gestational diabetes, oligo hydramnios and intrauterine growth retardation. One one pregnancy was 1.5 times more vulnerable for preeclampsia. Pregnancies with azoospermic and oligospermic partners had an increased risk for developing preeclampsia

Risk factors for lower respiratory tract infections in children

Acute respiratory tract infections are divided into two groups as upper and lower respiratory tract infections. These are very common diseases in childhood. In this study, we aimed to determine risk factors for lower respiratory tract in this region. Three hundred and fifty children who presented at pediatric polyclinics of our hospital were included in our study. Their examinations, backgrounds, family histories and information about environmental factors were recorded in questionnaire forms. Lack of vaccination, duration of breastfeeding, onset age of cow's milk, family history for asthma and food allergy, number of hospitalized people in the same room, number of people who live in same house and smoking around the children were evaluated for the presence of LRTI, and LRTI risks of these factors were respectively observed as 1.69, 1.71, 1.61, 1.69, 1.20, 1.47, 1.56 and 2.63 fold increased. Standardization of clinical diagnosis, accurate and realistic use of antibiotics, correction of nutrition, improvement of socio-economic situation and the elimination of environmental factors will significantly reduce morbidity and mortality in children due to Lower Respiratory Infections

Fukuyama congenital muscular dystrophy

Muscular dystrophy is an inherited group of disorders that affects skeletal and many other systems. It is transferred to the next generations with autosomal recessive trait. Congenital muscular dystrophy is a rare disorder characterized by findings emerging from birth. There are 12 different forms of mutation according to defects. Fukuyama syndrome is a rare form of congenital muscular dystrophies in our country. There is FKTN gene mutation. Because it is a rare disease in Turkey, we find this case to be worthy of presentation. After the delivery, patients with recurrent convulsion and hypotonia were admitted to pediatric emergency department. Patients were diagnosed as Fukuyama congenital muscular dystrophy after evaluation based on clinical findings, imaging techniques and gene analysis. Congenital muscular dystrophy should be considered, whereas it is a group of disease in which hypotonia and recurrent convulsions are seen in early infancy period

Distrophinopathy: a rare cause of elevated transaminase in newborn

Elavated transaminase levels are encountered in neonates and infancy because of several reasons. Muscular dystrophy is a rare hereditary disease compared to other disease causing elevation of transaminase. Some of them progress rapidly and result in death. Our case, who was born from a healthy non-relative marriage, delivered with NSD as term and weighed 3750g. Patient was admitted to the service with diagnosis of meconium aspiration syndrome and perinatal asphyxia due to being stained with meconium and having respiratory distress. The patient was examined because of elevated transaminase levels. There was no reason which could lead to elevation of transaminases derived from liver. We examined the patient in terms of myopathy because of the high level of creatinine kinase. Since the muscle biopsy was compatible with distrophinopathy, it was diagnosed as distrophinopathy. In children with prolonged transaminase levels, such clinical symptom may not be encountered. However, in these patients, it should be noted that rare myopathies may cause transaminase elevation. By reporting of this case we wanted to emphasize that determination of creatine kinase levels is important for early diagnosis

Spontaneous pneumomediastinum associated with subcutaneous emphysema causing brachial plexus palsy in a term newborn

Neonatal pneumomediastinum is a rare condition which often occurs during the setting of assisted ventilation of premature or diseased lungs. Brachial palsy occurs in presence of impression on cervical and throcal nerve roots due to birth-related trauma. In this case; we present a progressive spontaneous pneumomediastinum. Although subcutaneous emphysema was involving the whole neck, right cervical region was predominantly involved. Even though there was no diagnosed brachial palsy just after delivery, in time, we realized that the right arm was affected. In the literature, we couldn't find any reported case of spontaneous pneumomediastinum associated with subcutaneous emphysema causing brachial plexus palsy in neonatal period

Atypical presentation of congenital lymphedema

Lymphedema, lymphatic fluid is due to an abnormal accumulation in the body in a regional body edema. Congenital lymphedema represents all forms that are clinically evident at birth and accounts for 10-25% of all primary lymphedema cases. The patient was born from consanguineous parents as the first child after two abortion and history of a child death at 14 month of age. On examination the patient had pitting edema at all extremities and abdomen. Lymphangiosintigraphy was performed and no lymph nodes were seen so hereditary primary lymphedema diagnosis was confirmed. Primarily, often caused by a congenital anomaly or dysfunction. As a secondary, acquired disorder is caused by lymphatic flow. Congenital lymphedema, occurs in the first weeks of life. After resolution of the edema the patient was malnourished and had feeding problems. In English literature, congenital lymphedema case with organomegaly, ascites and pitting generalized edema is rarely defined. We report this case because of its unique presentation

EBV-induced fulminant hepatic failure treated with liver transplantation

Viral hepatitis is the leading cause of fulminant hepatitis. Infectious mononucleosis caused by primary infection of EBV is a self-limiting lymphoproliferative disease, and shows concomitant clinical features such as pyrexia, cervical lymphadenopathy, liver dysfunction and hepatosplenomegaly. Even though approximately more than 90 percent of all humans are infected with EBV it rarely causes hepatitis and even if it does it is usually benign and it rarely causes hepatic failure in which the outcome has a high mortality rate. We report a case of fulminant hepatic failure in an immunocompetent 3.5 years old girl caused by primary EBV infection that was treated by orthotropic liver transplantation. This observation emphasizes that EBV must be known as a possible cause of fulminant hepatitis and that liver transplantation is probably the unique therapeutic option to avoid a usually fatal course