A congenital proximal tracheoesophageal fistula 14 years after surgical repair of esophageal atresia with distal tracheoesophageal fistula

Congenital esophageal atresia with proximal and distal tracheoesophageal fistula occurs very rarely. This report describes late diagnosis of a congenital proximal fistula in a 14-year-old girl who underwent surgical repair of a congenital esophageal atresia with distal tracheoesophageal fistula on her first day of life and suffered recurrent bouts of lower airway infections and chronic cough, with the diagnosis of asthma in later childhood.     

Is meconium stained amniotic fluid related to occult myocardial injury in term low risk pregnancies?

Aim

The present study aimed to compare Troponin T (Tp T) levels of infants born with meconium stained amniotic fluid (MSAF) to those with clear amniotic fluid.

Study design

Case–control study

Subjects

Thirty-five women who had delivery complicated by MSAF between 37 and 41 weeks of gestation were defined as the study group and women with healthy uncomplicated pregnancies with clear amniotic fluid who were matched for age, parity, and gestational age were defined as the control group.

Outcome measures

Cord blood Tp T level, gas analysis and neonatal outcomes were compared between groups.

Results

Tp T levels of the study and control groups were 0.026 ± 0.013 ng/ml and 0.031 ± 0.016 ng/ml, respectively. The difference was not statistically significant (p = 0.132). On the other hand, the study group had a statistically lower HCO₃ level (21.80 vs 23.60 mmol/l ) and higher rate of base deficit (4.85 vs 3.25 mmol/l) than the control group.

Conclusion

The presence of meconium during labor is not related to occult myocardial injury in low-risk term pregnancies.     

Emergency contraception: Knowledge and attitudes of Turkish nursing and midwifery students

Objectives To assess the knowledge and attitudes of emergency contraception (EC) among nursing and midwifery students of a university in the Eastern-Mediterranean region of Turkey.

Methods The survey was conducted among 210 nursing and midwifery students.

Results One hundred and twenty-five participants (59.5%) knew at least one method of EC. One hundred and fourteen participants (54.3%) had heard about emergency contraceptive pills (ECPs), but only 17 (8.1%) knew what they contained. Rates of hearing about ECPs were statistically higher in third and fourth classes than first and second classes, and in midwifery students than in nursing students (P < 0.001). In spite of their very unsatisfactory level of knowledge, 166 students (79.0%) thought that ECPs should be sold in pharmacies.

Conclusion The nursing and midwifery students we assessed have a very insufficient knowledge of EC. Probably therefore, many are prejudiced against it. They should be much better acquainted with this modality of contraception since, after graduation, they will play an important role in the dissemination of information about EC in the population.     

Application of the new pediatric criteria and Tel Hashomer criteria in heterozygous patients with clinical features of FMF

Recently, a new set of criteria was established for the diagnosis of familial Mediterranean fever (FMF) in childhood. The aim of this study is to validate the new criteria set among heterozygous patients with clinical features of FMF. The study group consisted of FMF patients, who had a mutation at a single allele, who were followed in four pediatric nephrology–rheumatology centers in Turkey. Patients were evaluated by the new criteria set and also by the Tel Hashomer criteria. According to the new criteria, the diagnosis of FMF was established by the presence of two or more of five criteria (fever, abdominal pain, chest pain, arthritis, family history of FMF). The study group consisted of 110 FMF (54 male, 56 female) patients. Majority of the patients had heterozygous pM694V mutation (65%). The sensitivity of the new criteria set and that of the Tel Hashomer criteria in our study group were found to be 93% and 100%, respectively. In conclusion, this study designates that sensitivity of the new criteria set is also high in patients who had a mutation at a single allele.     

Does pregnancy-associated plasma protein A have a role in allergic rhinitis?

BACKGROUND: Pregnancy-associated plasma protein A (PAPP-A), also known as insulin-like growth factor binding protein 4 protease, is postulated to be a new inflammatory marker in various clinical situations such as cardiovascular events, dialysis, renal transplantation, and asthma. PAPP-A also is produced in high concentrations by trophoblasts during pregnancy. METHODS: We evaluated PAPP-A levels in allergic rhinitis patients and compared these with levels in healthy subjects. Thirty-one newly diagnosed allergic rhinitis patients and 29 healthy controls were included in the study. Serum PAPP-A, IgE, urea, creatinine, aspartate aminotransferase, creatine kinase (CK), CK-MB isoenzyme, total cholesterol, and triglyceride levels were determined. RESULTS: The serum PAPP-A level was significantly higher (p = 0.013) in the allergic rhinitis group (6.1 +/- 2.9 mU/L) than in the control group (4.5 +/- 1.7 mU/L). The PAPP-A level in patients with allergic rhinitis and asthma (6.1 +/- 2.3 mU/L) was not significantly different (p = 0.959) from that in patients with allergic rhinitis alone (6.1 +/- 3.3 mU/L). The serum PAPP-A level in allergic rhinitis patients who had turbinate hypertrophy (6.9 +/- 2.2 mU/L) had a tendency to be higher than that in patients who had no turbinate hypertrophy (5.5 +/- 3.2 mU/L); however, this difference was not statistically significant (p = 0.151). CONCLUSION: Increased PAPP-A activity may be involved in the inflammation and tissue remodelling that occurs in allergic rhinitis.