Objective: To evaluate the nutritional status of Turkish high school adolescents using anthropometric indicators and to determine the relationship of nutritional status with gender and socioeconomic status (SES) in adolescents.Methods: Six hundred eighty adolescent students (n=284 males, 396 females) aged 14−18 years were selected from 6 high schools of different regions. Nutritional status was evaluated according to the anthropometric indicators, which were based on the WHO criteria. Adolescents were grouped into three SES categories.Results: The rates of being stunted, underweight, and overweight/obesity were 4.4%, 5.0% and 16.8%, respectively. Height and weight standard deviation scores (SDS) were significantly lower in adolescents with low SES (p<0.05). The frequency of stunting was significantly higher in adolescents with low SES (p=0.012). Frequency of underweight, overweight and obesity did not differ significantly between socioeconomic groups and genders (p>0.05).Conclusion: Adolescents of low SES were shorter and thinner than those of other SES categories. Undernutrition needs to be addressed in low SES. Among all Turkish adolescents, the major nutritional problems were overweight and obesity. There were no SES and gender differences in prevalence of overweight and obesity among the Turkish school adolescents living in urban areas. Prevalence of obesity is rising, regardless of differences in SES and gender, in developing countries too.Conflict of interest:None declared.

The main purpose of this study is to determine the current status of long-term follow-up (LTFU) for childhood cancer survivors and the challenges of LTFU for pediatric cancer survivors at pediatric oncology institutions in Turkey. Material and methods:A questionnaire was e-mailed to the directors of 33 pediatric oncology centers (POCs) registered in the Turkish Pediatric Oncology Group (TPOG). Of these 33 active TPOG institutions, 21 participated in the study and returned their completed questionnaires.Results: Only 1 of the 21 participating centers had a separate LTFU clinic. The remaining centers provided LTFU care for childhood cancer survivors at the pediatric oncology outpatient clinic. Of these centers, 17 (80.9%) reported difficulty in transition from the pediatric clinic to the adult clinic, 14 (66.6%) reported insufficient care providers, and 12 (57.1%) reported insufficient time and transportation problems. As neglected late effects, 16 (76.1%) centers reported psychosocial and getty job problems and 11 (52.3%) reported sexual and cognitive problems. None of the centers had their own LTFU guidelines for their daily LTFU practice. Conclusion:This study was the first to gain an overview of the needs of POCs and the gaps in survivorship services in Turkey. The results from this study will help to develop a national health care system and national guidelines for pediatric cancer survivors.

Key wordsacute osteomyelitis, children, deep vein thrombosis, septic pulmonary embolism.Septic pulmonary embolism (SPE), deep vein thrombosis (DVT) and acute osteomyelitis (AOM) form a triad which is rarely seen in children. The association of DVT, SPE and AOM was first reported as a form of dissemine staphylococcal infection by Gorenstein et al . 1 This clinical syndrome is a life threatening disorder which necessitates urgent diagnosis and treatment. 2-4 SPE is manifested in a large number of patients with fever, cough and hemoptysis. The most common radiographic findings of SPE are the presence of multiple nodules of varying size located in the periphery of both lungs. 5 It is a frequent complication of right-sided bacterial endocarditis, septic thrombophlebitis, osteomyelitis, and urinary tract infections in adults, but there has been no comprehensive studies considering the etiological factors in childhood. 1,[5][6][7] In this article, we report a 3-year-old male patient who was diagnosed with SPE which presented along with the clinical findings of DVT on admission. CaseA 3-year-old boy presented to the Emergency Department, Faculty of Medicine, Celal Bayar University, with swelling and pain of the right lower extremity, and he was also limping. Physical examination revealed he had a temperature of 39 ° C. Chest examination revealed diminished breath sounds on the right side in comparison with those on the left side. The right lower extremity was edematous and tender, and the pulses of the right foot were non-palpable.Laboratory results showed: hemoglobin 10.7 mg/dL, WBC 8,000/mm 3 , with 72% neutrophils 26% lymphocyte, 2% immature neutrophils in blood smear, platelets 257,000/mm 3 , erythrocyte sedimentation rate 94 mm/h, C-reactive protein 106 mg/dL (normal: 0-5 mg/dL).Genetic and acquired coagulation disorders predisposing DVT were not detected. Activity of protein C was 89% (normal: 70-140), activity of Protein S was 66% (normal: 60-140), activity of antitrombin III was 117% (normal: 80-120), antinuclear antibody negative, Anticardiolipin antibody IgG negative and IgM negative, Rheumatoid factor negative, C3-complement was 1.3 g/dL (normal: 0.08-0.2) and C4-complement was 0.9 g/dL (normal: 0.16-0.47). Factor-5 Leiden mutation and protrombin mutation were not detected.Doppler ultrasound revealed subacute thrombosis of the right external iliac vein which was extended to the popliteal vein (Fig. 1). His chest radiograph taken during admission showed bilateral multiple nodular densities and a right pleural effusion. Chest computed tomography (CT) revealed bilateral multiple nodular densities; some of them were transformed cavities in the parenchyma of both lungs (Fig. 2). SPE and DVT were suspected due to the coexistence of these radiologic findings and clinical features. Lowmolecular-weight heparin (enoxaparin), aminosalicylic acid, vancomycin, amikacin and extremity elevation were instituted as the initial treatment. On the 8th day of his hospitalisation, his bone radiographic findings showed AOM of the r...

Although veno-occlusive disease of the liver is a well-known complication of high-dose chemotherapy and bone marrow transplantation, it has rarely been observed in children who receive conventional chemotherapy. Most cases in the literature consists of children with Wilms tumor. It has been very uncommon in rhabdomyosarcoma patients until recently, although they commonly receive similar anticancer agents. Here the authors report a 2-year-old boy with rhabdomyosarcoma who developed veno-occlusive disease while receiving VAC (vincristine, actinomycin D, cyclophosphamide) chemotherapy regimen according to the IRS-IV protocol. The patient gradually recovered during 2 weeks with supportive treatment only.

Objective:To investigate the possible protective effect of a single dose of ketamine and the synergistic effect between ketamine and 2-mercaptoethane sulfonate (mesna) against ifosfamide-induced hemorrhagic cystitis.Materials and Methods:35 adult female wistar rats were divided into five groups and pretreated with ketamine at 10 mg/kg and/or mesna 400 mg/kg 30 minutes before intraperitoneal injection of IFS (400 mg/kg) or with saline (control group). Hemorrhagic cystitis was evaluated 24 hours after IFS injection according to bladder wet weight (BWW), and microscopic changes, i.e. edema, hemorrhage, cellular infiltration, and urothelial desquamation. The markers of oxidative damage including nitric oxide (NO) and malondialdehyde (MDA) levels and the expressions of tumor necrosis factor alpha (TNF-α), interleukin 1-beta (IL-1β), inducible nitric oxide synthase (i-NOS) and endothelial nitric oxide synthase (e-NOS) were also assayed in the bladder tissues.Results:Pretreatment with ketamine alone or ketamine in combination with mesna reduced the IFS-induced increase of BWW (58,47% and 63,33%, respectively, P < 0.05). IFS- induced microscopic alterations were also prevented by ketamine with or without mesna (P < 0.05). In addition, also statistically insignificant, the bladder tissue expressions of IL-1β were lower in ketamine and/or mesna-receiving groups (P > 0,05). The parameters of oxidative stress, the NO and the MDA contents of the bladder tissues of the study groups were not different.Conclusion:The results of the present study suggest that a single dose of ketamine pretreatment attenuates experimental IFS-induced bladder damage. It is therefore necessary to investigate ketamine locally and systematically with various dosing schedulesin order to reduce the bladder damage secondary to oxazaphosphorine-alkylating agents and these results may widen the spectrum of ketamine.