A novel association between cerebral sinovenous thrombosis and nonketotic hyperglycinemia in a neonate / 소아과

Lethargy in newborns usually indicates central nervous system dysfunction, and many conditions such as cerebrovascular events, infections, and metabolic diseases should be considered in the differential diagnosis. Nonketotic hyperglycinemia is an autosomal recessive error of glycine metabolism, characterized by myoclonic jerks, hypotonia, hiccups, apnea, and progressive lethargy that may progress to encephalopathy or even death. Cerebral sinovenous thrombosis is a rare condition with various clinical presentations such as seizures, cerebral edema, lethargy, and encephalopathy. Here, we report the case of a newborn infant who presented with progressive lethargy. An initial diagnosis of cerebral venous sinus thrombosis was followed by confirmation of the presence of nonketotic hyperglycinemia.

Methodology of national Turkey nutrition and health survey [tnhs] - 2010

The purpose of this paper is to explain the methodology of National Turkey Nutrition and Health Survey [TNHS] - 2010. The survey was conducted with the aim of providing the necessary data on nutrition and health to plan and develop related food, nutrition and health policies in Turkey and the study was conducted in collaboration with Ministry of Health, Hacettepe University Faculty of Health Sciences Department of Nutrition and Dietetics, and Ankara Numune Training and Research Hospital. TNHS sample was designed as a weighted, multi-stage, stratified cluster sample. To stratify the sample, TNHS adopted the stratification approach used in the 2008 Turkey Demographic and Health Survey that allows making estimates nation-wide and for the 5 regions, the 12 NUTS-1 regions, and the 7 metropolitans. Survey provided detailed information on dietary intake, physical examination including clinical and biochemical variables, physical activity status and anthropometric measurements. The survey sample was designed to represent the population of Turkey in age groups of 0-5 and >/= 6 years, the baseline nutrition and health status and blood and urine tests of >/= 6 year-old individuals.

The Effect of Surgery Time on Prognosis in Newborns with Meningomyelocele

OBJECTIVE: To investigate the effect of surgery time on prognosis of newborns with meningomyelocele. METHODS: The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded. RESULTS: The records of 30 babies were included in the final analysis. Overall, the mean gestational age was 37.7+/-2.7 weeks, with a mean birth weight of 2967+/-755 g and head circumference of 35.8+/-3.8 cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33+/-1.2 cm. Newborns underwent surgery on average of 8.2+/-5.9 days after birth, with an overall mean duration of hospital stay of 30+/-25.1 days. Patients were divided into two groups based on timing of surgery (group 1, 5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05). CONCLUSION: Early surgical intervention (< or =5 days) was associated with a shorter duration of hospital stay and antibiotic therapy as well as a lower complication rate. We recommend that corrective surgery be undertaken as soon as reasonably possible.

views of new graduate physicians about compulsory service in Turkey

The objective of this study is to analyze the views of new graduate physicians on compulsory service. This is an important study because it is the first study on the views of new graduate physicians on compulsory service prior to their employment in Turkey. This study was conducted in Turkey in August 2008. All new graduate physicians prior to employment were included in the study, who filled out online questionnaires [Response Rate = 65.9%]. Variables impacted physicians' views on compulsory service were analyzed. The total number of physicians tends to be less in relatively underdeveloped areas. A total of 49.0% of physicians found the practice of compulsory service useful. There is a statistically significant relationship between the views on the efficiency and need for compulsory service, and the choice of being a physician, regretting being a physician after being employed, and the views on solutions toward the maldistribution of physicians [P<.05]. The practice of compulsory service is beneficial for balancing the physician density in regions. Health Transformation Program [2003] activities are improving the inequality among the regions. Different policies should be developed and given to physicians to encourage them work in underdeveloped regions; they should also be made to see the health care need in the regions with fewer health care workforce. It is important to take these issues into consideration when developing policies toward the solution of this problem

Success of decreasing neonatal mortality in Turkey

Neonatal mortality rate has been higher in Turkey, 26/1000 in 1998, whereas 10/1000 in 2009. Within 11 years due to the advances in health policy, Turkey achieved a significant decrease in neonatal mortality, that Organisation for Economic Co-operation and Development countries reached within 30 years. In order to determine prenatal, natal and early postnatal health care and to introduce new goals to preserve more qualitified health service throughout the country, "Infant Death Registry-Report Form" was formed by the leadership of Health Ministry of Turkey in 2005. This was the first step to be aware of the number and the causes of the neonatal deaths. Close antenatal care, ttendance of skilled personnel to the deliveries, encouraging breastfeeding, prevention of hospital infections are some of the prevention strategies whereas standardized neonatal resuscitation programme wholeout the country, improvement of neonatal intensive care units and transportation conditions, increased number of skilled health personnel are the treatment solutions

Pneumomediastinum with underlying cause of congenital pneumonia in a preterm infant: a case report

Pneumomediastimum is defined as a mediastinal air leak. Neonatal pneumomediastinum occurs in approximately 2.5 per 1000 live births. The diagnosis is usually confirmed by frontal chest roentgenogram. In this case we want to report penumomediastinum with a rare underlying cause of congenital pneumonia and to highlight the diagnosis could not always be done simply based on chest X-ray and also should benefit from other ancillary imaging methods

What is your diagnosis?

A male preterm infant, first-born of twins delivered by cesarean section at 31 weeks' gestation. Birth weight was 1720 g and APGAR scores were 5 and 8 at 1 and 5 min, respectively. The initial clinical course of the infant was unremarkable except mild respiratory distress which required supplemental oxygen. Enteral feeding with breast milk was started at 16 hours of age and increased with amounts of 20 ml/kg/day over the next days. On day 5 of life, clinical deterioration occurred with fecaloid vomiting, abdominal distention and bloody stools. Serum C-reactive protein and interleukin-6 levels were 37,8 mg/L and 482,1 pg/mL, respectively. Throm-bocytopenia [118x10[6]L] was detected. White blood cell count and immature-to-total ratio of the blood count remained normal. What is your diagnosis of the infant whose abdominal graph is shown below?