İdrar yolu enfeksiyonları (İYE) çocukluk yaş grubunda en sık karşılaşılan enfeksiyonlar arasındadır. Bu çalışma ile üçüncü basamak bir hastanede idrar yolu enfeksiyonlarında etiyolojik ajanların değerlendirilmesi, antimikrobiyal direnç paternlerinin belirlenmesi, ampirik tedavi önerilerinin gözden geçirilmesi amaçlandı. Gereç ve Yöntemler: Hacettepe Üniversitesi İhsan Doğramacı Çocuk Hastanesi yataklı servis ve polikliniklerinden 01.01.2012-31.12.2015 tarihleri arasında hastanemiz mikrobiyoloji laboratuvarına gönderilen ve Gram negatif (-) üreme saptanan 4421 idrar örneğinin kültür ve antibiyogram sonuçları retrospektif olarak değerlendirildi. Bulgular: Gram negatif üreme saptanan 4421 örnekten %64.1'inde Escherichia coli, %17.1'inde Klebsiella spp, %7.4'ünde Proteus spp üremesi saptandı. Tüm gram negatif mikroorganizmalar birlikte değerlendirildiğinde; en yüksek direnç ampisilin (%75.1), sefazolin (%59), ampisilin-sulbaktam (%49.7), trimetoprim-sulfametoksazol (TMP-SMX) (%45.2), sefiksim (%33.1) ve seftriaksona (%31.4) karşı saptandı. En düşük direnç meropenem (%3.2), ertapenem (%3.4), kolistin (%7.2), amikasin (%16.2), siprofloksasin (%21.1), piperasilin tazobaktama karşı (%23.2)'di. Sonuç: Çalışmamızda çocukluk çağı idrar yolu enfeksiyonlarında ilk seçenek olarak kullanılan birinci kuşak sefalosporinlere, ampisilin, ampisilin-sulbaktam ve TMP-SMX'e karşı yüksek direnç saptanmıştır. Tedavide başarılı olabilmek, morbidite ve uzun dönem sekellerini en aza indirebilmek için İYE nedeni olan patojenlerin sıklığı, yerel veya bölgesel antibiyotik dirençlerinin bilinmesi ve bu doğrultuda ampirik tedavinin düzenlenmesi gereklidir.
The genetic cause of 46, XY disorder of sex development (DSD) still cannot be determined in about half of the cases. GATA-4 haploinsufficiency is one of the rare causes of DSD in genetic males (46, XY). Twenty-two cases with 46, XY DSD due to GATA-4 haploinsufficiency (nine missense variant, two copy number variation) have been previously reported. In these cases, the phenotype may range from a mild undervirilization to complete female external genitalia. The haploinsufficiency may be caused by a sequence variant or copy number variation (8p23 deletion). The aim of this study was to present two unrelated patients with DSD due to GATA-4 variants and to review the phenotypic and genotypic characteristics of DSD cases related to GATA-4 deficiency.
Background: To evaluate the ocular symptoms and findings of children diagnosed with Crimean-Congo hemorrhagic fever (CCHF). Methods: In this prospective study, children diagnosed with CCHF who underwent a complete ophthalmologic examination during the hospitalization period were included. Results: Twenty-four children with a mean age of 12.4 ± 3.6 years were included study. The most common ocular finding was conjunctival hyperemia and was observed in 50% of patients. Nine (37.4%) children had abnormalities in fundus examination. Two (8.3%) of them had dilated retinal veins, and 7 (29.1%) had tortuous retinal vessels. No significant difference was found between mild to moderate and severe disease groups in terms of ocular symptoms and ophthalmologic examination findings (P > 0.05, for all). Conclusions: The increased retinal vessel tortuosity was detected as a fundus examination finding in children with CCHF. Both ophthalmologists and pediatricians should be aware of the various ocular manifestations of CCHF for rapid diagnosis and management.
Background. Given the high prevalence of potentially traumatic events (PTEs), pediatric providers are in a novel position in early identification and referral of the children with PTEs. Yet paucity of culturally adapted instruments to screen PTEs and related symptoms in preschool-aged children limits pediatric providers. This multicenter study aimed to screen the traumatic life events of preschool-aged children admitted to pediatric outpatient clinics at four different cities of Turkey and to determine the socio-demographic risk factors associated with PTEs. Moreover, it was also intended to develop the cultural adaptation of the Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 Years version to Turkish and to analyze its reliability. Methods. Participants of this multicenter study were collected from four different hospitals in three different regions (Central Anatolia, Black Sea, and Southeastern Anatolia regions) of Turkey. All parents of children at the age of 3-6 years who were admitted to the hospital for a clinical visit (sick-child or well-child visits) were invited to the study. In total, 188 preschool-aged children were included in the study. Socio-demographic characteristics of the child and the family were questioned and parents were asked to fill out the Turkish version of the CATS Caregiver-report. Results. Internal consistency (Cronbach`s alpha) of the Turkish version of the CATS Caregiver-report 3-6 Years was found as 0.86. This study revealed that half of the participating children had experienced at least one PTE and more than one fourth experienced more than one event. Strikingly, no association between sociodemographic risk factors and PTE exposure was identified suggesting that PTE exposure is indeed widespread in our study population. Conclusion. The findings of this study manifest the importance of routine screening of PTEs and related symptoms in children.
Objective: Crimean-Congo hemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. CCHF first emerged in Turkey in 2002, and the prevalence of the disease has been found to be increased. Central Anatolia Region is endemic for the disease where sporadic cases or even outbreaks are being observed every year. The study was aimed to evaluate sociodemographic, clinical and laboratory parameters of children admitted due to tick bite and prediagnosis of CCHF and to discuss necessity of repeated blood sampling in asymptomatic cases.
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