Epidemiologic analysis of patients with burns presenting to the burn units of a University Hospital Network in Turkey.

This retrospective study analyzed risk factors in addition to the demographic and epidemiological features of 813 burn patients who were admitted to the burn units of a University Hospital Network in Turkey during a 6-year period. The study consisted of 436 men (53.6%) and 377 women (46.4%; mean age, 31; range, 0-87 years). The age distribution of the patients peaked at 1 to 6 years and at 35 to 44 years. The most common types of burns were scalds (63.8%) and flame burns (22.1%). The mean TBSA burned was 9.4 +/- 15.3% in adults and 19.8 +/- 18.6% in children. The median and mean hospital stays were 16 and 22.8 days, respectively (range, 1-114 days). A total of 813 patients were evaluated, leaving only 255 hospitalized patients. Of the hospitalized patients, 100 (74.6%) underwent autografting, 8 (6.0%) underwent amputation, 113 (84.3%) underwent débridment, and 76 (56.7%) underwent escharotomy. The mortality rate among hospitalized patients was 14.1%. Although this study provides information about the population within close proximity to our burn units, there remains a need for a countrywide database of burn incidents.

Neurofibromatosis--Noonan's syndrome with associated rhabdomyosarcoma of the urinary bladder in an infant: case report.

Neurofibromatosis 1 is an autosomal dominant disorder. Noonan's syndrome is known to be associated with neurofibromatoses. Patients with neurofibromatosis are predisposed to developing malignant tumors. The relationship between the genetic changes in the neurofibromin gene and mechanisms associated with tumor development in neurofibromatosis has been investigated. A non-sense mutation C2446T --> R816X of the neurofibromin gene has been detected in some patients with the neurofibromatosis 1-Noonan's syndrome phenotype. We describe a case of an infant with the overlapping features of neurofibromatosis 1 and Noonan's syndrome who presented with rhabdomyosarcoma of the urinary bladder. The genetic analysis of our patient revealed neither mutation in the neurofibromatosis 1-guanosine triphosphatase-activating protein-related domain nor the R816X nonsense mutation. The phenotypic and genotypic features of neurofibromatosis, Noonan's syndrome, and cases with the overlapping features of both syndromes have been reviewed. The presentation of our case underlines the importance of careful examination for the clinical features of neurofibromatosis and phenotypic traits of associated diseases, especially in patients with malignant tumors.

Transanastomotic stents for dismembered pyeloplasty in children.

Among pediatric urologists, there is a debate whether to drain the upper system after pyeloplasty in children. In a prospective, randomized clinical study we compared the early and late results of patients operated upon for ureteropelvic junction obstruction (UPJO) with or without a transanastomotic stent. Anderson-Hynes pyeloplasty was performed in 31 children during a 5-year period. In 15 a transanastomotic stent with multiple holes was used; the upper system was not drained in 16. A Penrose drain was placed in the perinephritic area in all patients. Patients were evaluated in regard to the time of removal of the stent and the Penrose drain, duration of urine leakage, and duration of hospital stay in the early postoperative period, and favorable or unfavorable outcome during follow-up. The statistical analysis showed no significant difference in regard to the removal time of the stent and Penrose drain, duration of drainage, duration of hospitalization, and early or late complications between the groups. Although stenting does not increase morbidity, we believe that pyeloplasty can be performed in children without upper-tract drainage. A feeding tube with multiple holes at the tip is recommended.