Should children with infection be tested for lipid,lipoprotein and apolipoprotein?

The lipid profile is known to alter in patients with infection, but there has not been a study of the apolipoprotein levels in serum of otherwise healthy children during infection. Lipids, lipoproteins, apolipoproteins A-l and B and lipoprotein (a) were evaluated prospectively in 31 consecutive children, aged4–15 years, who were admitted to the hospital with bacterial pharyngitis. The degree of dyslipidemia associated with bacterial pharyngitis was assessed using each child as his/her own control and by comparison with 79 healthy children who had not had an infection during the past 3 months. Serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein A-l and apolipoprotein B levels were significantly decreased during the symptomatic phase of the disease, whereas the serum triglyceride level was slightly elevated. Serum lipoprotein (a) concentration did not change significantly. In conclusion, it is suggested that serum lipids, lipoproteins and apolipoproteins should not be assessed during infection because of the possible transient changes of these parameters during infection or inflammation.     

The prevalence of molar incisor hypomineralization (MIH) in a group of children in a highly polluted urban region and a windfarm-green energy island

Backround.  Children's developing teeth may be sensitive to environmental pollutants such as polychlorinated dibenzo- p -dioxins (PCDDs) and polychlorinated dibenzofurans. The term molar incisor hypomineralization (MIH) was introduced to describe the clinical appearance of enamel hypomineralization of systemic origin affecting one or more permanent first molars (PFMs) that are associated frequently with affected incisors.
Aim.  The aim of this study was to determine the prevalance of MIH in children from the most industrialized and polluted region and the most green-energy island of Turkey.
Design.  In September 2007, a retrospective study was initiated in two elementary schools: one, a group of children ( N  = 153) who fitted the criteria from Tavsancil, Kocaeli ( N  = 109) and the other from Bozcaada island, Canakkale ( N  = 44). The soil samples were collected from selected regions in order to determine the contamination levels in a heavily industrialized area and a non-industrialized area.
Results.  Prevalance of MIH in children in Bozcaada island was 9.1%, while prevalance of MIH was 9.2% in Tavsancil. The PCDD/F levels in soil samples collected from Bozcaada and Tavsancil were determined as 1,12 and 8,4 I-TEQ ng/kg dry soil, respectively ( P  < 0.001).
Conclusions.  In this preliminary study with a small study population, prevalence of MIH did not seem to be associated with the levels of PCDD/Fs in the environment.     

Waardenburg Syndrome Type I with Heterochromia Iridis and Circumscribed Hypopigmentation of the Skin

Abstract: We report a 3‐year‐old girl with autosomal dominant inherited Waardenburg syndrome type I showing circumscribed hypopigmentation of the skin, heterochromia iridis, sensorineural deafness, and dental aberrations. Clinical diagnosis was confirmed by the identification of an underlying missense mutation (C811T) in the PAX3 gene. Early diagnosis of Waardenburg syndrome among children with pigment anomalies enables a successful interdisciplinary medical care.     

Comparison of Phenol and Sodium Hydroxide Chemical Matricectomies for the Treatment of Ingrowing Toenails

OBJECTIVE: Chemical matricectomy is performed mainly by two agents: phenol and sodium hydroxide. Both agents have excellent cure rates, but there are no data about the comparison of postoperative healing periods. This study was designed to compare the postoperative morbidity rates of sodium hydroxide and phenol matricectomies. MATERIALS AND METHODS: Forty-six patients with 154 ingrowing nail sides were treated with either sodium hydroxide or phenol matricectomy. In the postoperative period, the patients were evaluated for the duration and severity of pain, drainage, and peripheral tissue destruction; complete healing periods; and overall success rates. RESULTS: The incidence of pain was higher in the sodium hydroxide group on the first visit, on the second day, but all patients became pain-free after that. The incidence and duration of drainage and peripheral tissue destruction was significantly higher in the phenol group. The mean period for complete recovery was 10.8 days in the sodium hydroxide group, whereas it was 18.02 days in the phenol group. The overall success rates in the sodium hydroxide and phenol groups were found to be 95.1 and 95.8%, respectively. CONCLUSION: Both sodium hydroxide and phenol are effective agents giving high success rates, but sodium hydroxide causes less postoperative morbidity and provides faster recovery.     

Right Atrial Pacemaker Lead Thrombosis Causing Tricuspid Inflow Obstruction

A 75-year-old man was admitted to our hospital with a complaint of progressive dyspnea with effort. The patient had a permanent pacemaker that was implanted 16 years ago. Transesophageal echocardiography revealed a large, mobile mass in the right atrium attaching to the insertion site of the atrial lead at the tricuspid valve level. Because of the size, mobility, and location of the mass, urgent surgical removal was considered. The mass was successfully removed. Histologic examination of the mass demonstrated a partially organized thrombus. The postoperative course was uneventful and the patient's symptoms improved remarkably after operation.     

Recombinant human growth hormone treatment in children with thalassemia major

BACKGROUND: To evaluate the growth hormone reserve and the growth hormone response to recombinant human growth hormone (GH) in prepubertal thalassemic children with growth retardation. METHODS: Twenty thalassemic patients with short stature and delayed bone age were studied. Patients were randomized into GH-treated (n = 10) and non-GH treated (control; n = 10) groups. The GH-treated group received recombinant human (rh)-GH (Genotropin) at the dose of 0.7 IU/kg per week for 12 months. RESULTS: There was a significant discordance between GH response to pharmacologic stimuli and physiological secretion of GH/GHRH testing. Following the administration of rhGH, growth velocity increased from 2.47 +/- 0.48 cm/year to 6.27 +/- 0.76 cm/year (P = 0.005), whereas there was not a similar change in the non-GH-treated group. The height velocities of the two groups during the 1 year follow-up period were significantly different (6.27 +/- 0.76 vs 3.99 +/- 0.34 cm/year; P = 0.025). There were significant differences between the height velocity improvements and height velocity standard deviation scores of the two groups as well. CONCLUSION: The present study has demonstrated that rhGH is a safe and efficacious mode of treatment in thalassemic children.     

Primary bilateral spermatocele

We report the case of a bilateral, relatively huge, multilocular spermatocele diagnosed at sonography with surgical and pathological correlation. A 45-year-old man presented with bilateral, large inguinoscrotal masses. He had had the masses since his adolescence and their size gradually increased in the past 5 years. Scrotal ultrasonographic examination showed cystic fluid masses that were 65 x 45 x 50 mm in size on the right and 55 x 45 x 40 mm in size on the left side in multilocular spaces. The cystic masses were excised via bilateral inguinoscrotal incision staying near the body of the epididymis. The patient had fathered three children with no fertility problem.     

Psychological trauma of circumcision in the phallic period could be avoided by using topical steroids

OBJECTIVE: The objective of our study was to assess the efficacy of topical steroids in the treatment of phimosis and evaluate patients using the Diagnostic and Statistical Manual-III-Revised (DSM-III-R) test with the aim of eliminating castration anxiety of circumcision in the phallic period. METHODS: One hundred and forty-nine children with phimosis who required circumcision were included the study. The average age of the children was 4.47 years. All children underwent the DSM-III-R test and their parents were questioned. Patients were separated randomly into three groups. Group I comprised 51 children who would undergo circumcision; group II comprised 50 children who would be treated with a topical corticosteroid (0.05% bethamethasone cream) twice daily for 1 month; and group III comprised 48 children who would be treated with a topical placebo cream. On the 5th day of treatment, parents were told to retract the prepuce and were given hygiene routine instructions. Patients were seen immediately after treatment and again 2 months later. RESULTS: In group II, 16 of the 50 children had non-retractable prepuce. Forty-two cases of phimosis were corrected after treatment. Eight patients received further monthly treatment and five benefited from the second course of treatment. In group III, 17 of the 48 patients had non-retractable prepuce and four had satisfactory results. Forty-four patients received placebo treatment for another month and eventually, 40 children underwent circumcision in this group. DSM-III-R test results showed a significant shift to anxiety in the circumcision group. The were no significant differences in the other groups. CONCLUSION: Topical steroids for the treatment of phimosis is a highly effective treatment alternative to surgery. It avoids or delays circumcision and can be practised during the phallic period to decrease castration anxiety. The treatment is suitable for patients from any religious or cultural background.