Assessment of Tear Film Anomalies in Childhood Obesity.

PURPOSE: To determine if childhood obesity has an effect on the ocular surface and tear film of children who are afflicted. METHODS: Patients who had childhood obesity, 85 eyes, and patients who were healthy, 75 eyes, were enrolled in this prospective and comparative study. The tear film breakup time (TF-BUT), tear meniscus area and height (TMA and TMH) values, Schirmer test scores, and ocular surface disease index (OSDI) scores were obtained for all participants. RESULTS: The TMH, TMA, TF-BUT, and Schirmer test results were statistically significantly lower in the obesity group (p < 0.001 for all). The children with obesity and insulin resistance had lower TMH, TMA, TF-BUT, and Schirmer test results when compared to the children without insulin resistance (p < 0.05 for all). The body mass index was found to be correlated with the TMH, TMA, TF-BUT, and Schirmer test results (p < 0.001 for all). CONCLUSION: Children with obesity had lower TMA, TMH, TF-BUT, and Schirmer test results than healthy subjects. When insulin resistance was added to obesity, these values were even lower.

Evaluation of QuantiFERON tuberculosis Gold In-Tube assay for diagnosis of active tuberculosis in children.

AIM: Tuberculin skin test (TST) is still used in diagnostic algorithms of childhood tuberculosis (TB). QuantiFERON TB Gold In-Tube assay (QFT-GIT) is an alternative test to TST based on the detection of interferon-gamma release upon in vitro induction of peripheral mononuclear cells by TB antigens. In this study, we aimed to determine the diagnostic value and performance of QFT-GIT for active childhood TB. METHODS: This retrospective study was conducted between January 2005 and December 2011 in three referral hospitals in Turkey with 124 children who were diagnosed with definite active TB. Sensitivity values of TST and QFT-GIT were determined by accepting the microbiological confirmation as the gold standard of diagnosis of TB. RESULTS: In our study, sensitivity of QFT-GIT and TST was found to be 65 and 66% respectively. However, combined usage of QFT-GIT and TST was found to be more sensitive (85%) than TST or QFT-GIT alone (P < 0.0001). Although negative results of QFT-GIT or TST did not exclude the diagnosis of active TB in children, their positivity supported the diagnosis. Specificity could not be measured as only microbiologically confirmed cases of Mycobacterium tuberculosis disease were enrolled in the study. CONCLUSION: Although sensitivities of TST and QFT-GIT are too low to exclude active TB, their positivity supports diagnosis of active TB in children concomitant with signs and symptoms. QFT-GIT and TST should be used together to enhance diagnostic sensitivity and could help exclude a diagnosis of TB if the pretest probability is low.

Magnusiomyces capitatus Peritonitis in a Child With Acute Lymphocytic Leukemia as a Breakthrough Infection During Caspofungin Therapy.

Magnusiomyces capitatus is an emerging opportunistic fungal pathogen particularly in immunocompromised patients. We report a case of a M. capitatus peritonitis in child with acute lymphocytic leukemia as a breakthrough infection during caspofungin therapy. The possibility of breakthrough infections caused by M. capitatus must be taken into consideration, particularly in immunosupressed patients being treated for systemic fungal infections by caspofungin. Although there are no defined breakpoints for susceptibility testing of M.capitatus, minimal inhibitory concentration results can be helpful for therapy. Antifungal treatment with amphotericin B lipid complex plus flucytosine can be effective against infections caused by M. capitatus.

Corynebacterium propinquum bronchopneumonia in a child with ataxia telangiectasia.

Nondiphtherial Corynebacterium species isolated from clinical specimens are usually considered as contaminants by many clinicians when reported by microbiologists. However, an increasing number of studies have confirmed the importance of Corynebacterium spp. in the etiology of a variety of infectious processes. In this report, we present a case of bronchopneumonia caused by Corynebacterium propinquum. The infection occurred in a seven-year-old child who had a history of immunosuppression due to ataxia telangiectasia. The purulent sputum of the patient yielded a large number of polymorphonuclear leucocytes with abundant gram-positive coryneform bacilli in gram staining and pure growth of coryneform bacteria in culture. Definitive identification as C. propinquum was made by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. C. propinquum should be recognized as a potential pathogen and included in the etiologic diagnostic algorithm, particularly in patients with immunosuppressive conditions.

Association between maternal depression and wheezing in preschool children.

The aim of this study was to assess whether maternal depression was associated with recurrent wheezing attacks in preschool children. A case-control study was conducted involving 51 preschool children who were hospitalized due to wheezing attacks and 50 age-matched healthy subjects. Sociodemographic characteristics of the children and their mothers were investigated. The Beck depression inventory was administered to the mothers. In the case group, the anthropometric measurements were determined to be significantly lower than in the control group (p < 0.05). The rate and severity of maternal depression were significantly higher (p < 0.05) in mothers of cases. Multivariate regression analysis indicated that male gender of the child and maternal history of asthma were significant risk factors for maternal depression (odds ratio 4.671; 95% CI 1.21-18.11 and 5.263, 95% CI 1.05-32.42, respectively). Having a male child with wheezing attacks and a history of maternal asthma were identified as important risk factors for maternal depression.