The aim of this retrospective study was to evaluate our neonatal intensive care unit (NICU) patients' characteristics treated with acute peritoneal dialysis (PD) and their risk factors for mortality. We also wanted to share our experience of the application of PD in neonates who required less than 60 mL of dwell volume and their PD-related problems, as well as special solutions for these problems. This study included 27 infants treated in our NICU between February 2008 and December 2011. We retrospectively analyzed these patients' records. The percutaneous PD catheter was placed by us. PD procedure was performed either by manual technique or automated PD. Statistical evaluation was performed by using χ(2)-tests and Student's t-tests. In these 27 neonates, the average gestational age and birth weight were 35.18 ± 4.02 weeks and 2534.62 ± 897.41 g, respectively. The mean PD duration time was 6.11 ± 6.30 days. Of these, 10 patients were treated by manual technique, whereas 17 patients were treated with automated system. Among 27 neonates, 16 patients died. Overall mortality rate was 59.25%. PD-related complications were seen in 25.92% of patients. In conclusion, PD application is less effective and troublesome for low-birth-weight infants. Each center should create its own solutions to accommodate problematic patients in PD treatment to improve the outcome in this special population.

Many new features have recently been incorporated to ÇEDD Çözüm/Child Metrics, an online and freely accessible scientific toolset. Various auxological assessments can now be made with data of children with genetic diseases (Prader Willi syndrome, Noonan syndrome, Turner syndrome, Down syndrome, and Achondroplasia) and preterm and term newborns. More detailed reports for height, weight, and body mass index data of a given child are now available. Last but not least, office and 24-hour ambulatory blood pressure values can be analyzed according to normative data. Abstract 125 J Clin Res Pediatr Endocrinol 2020;12(2):125-129 126 Demir K et al. Updates in Child Metrics J Clin Res Pediatr Endocrinol 2020;12(2):125-129 Blood Pressure (BP)BP values normally increase with age as the body grows; thus, comparing BP levels in mmHg among children are misleading. Instead, SD scores of office and ambulatory BP measurement (ABPM) values should be used.

We evaluated the predictors of renal scar in children with urinary tract infections (UTIs) having primary vesicoureteral reflux (VUR). Data of patients who were examined by dimercaptosuccinic acid (DMSA) scintigraphy between 1995 and 2005 were evaluated retrospectively. Gender, age, reflux grade, presence/development of scarring, breakthrough UTIs, and resolution of reflux, were recorded. The relation of gender, age and VUR grade to preformed scarring and the relation of gender, age, VUR grade, presence of preformed scarring, number of breakthrough UTIs and reflux resolution to new scarring were assessed. There were 138 patients [male/female (M/F) 53/85]. Multivariate analysis showed that male gender [odds ratio (OR) 2.5], age > or = 27 months in girls (OR 4.2) and grades IV-V reflux (OR 12.4) were independent indicators of renal scarring. On the other hand, only the presence of previous renal scarring was found to be an independent indicator for the development of new renal scar (OR 13.4). In conclusion, while the most predictive variables for the presence of renal scarring among children presenting with a UTI were male gender, age > or = 27 months in girls, and grades IV-V reflux, the best predictor of new scar formation was presence of previous renal scarring.

OBJECTIVES: The aim of this study was to determine the effi cacy of pulse steroid therapy administered to patients critically ill with COVID-19 progressing into severe pneumonia. METHODS: A total of 600 patients included in this retrospective study were divided into three groups. Group 1 (control group): 200 patients who did not receive steroid treatment, Group 2: 200 patients who received dexamethasone 1x8 milligram (mg) or methylprednisolone 1x80 mg, Group 3: (pulse steroid therapy group): 200 patients who received 1 g methylprednisolone followed by 1x80 mg methylprednisolone. Demographic and laboratory data were recorded. RESULTS: Mortality rates in groups 1, 2 and 3 were 77 %, 53.55 %, and 58.5 %, respectively. The ratios of intubated patients in groups 1, 2 and 3 were 70 %, 45.5 % and 56 %, respectively. The numbers of patients whose D-dimer values were above 2,250 ng/mL (cut-off value for D-dimer in this study) in groups 2, 1 and 3 were 65, 107, and 105, respectively. CONCLUSION: Pulse steroid therapy does not shorten the duration of hospital stay, does not reduce the need for intubation and increases the risk of thrombosis by signifi cantly increasing the level of D-dimer among patients critically and severely ill with Fig. 3, Ref. 20).

Adenosine deaminase 2 (ADA2) deficiency is a cause of vasculopathy that is coded by the CECR1 (Cat Eye Syndrome Chromosome Region 1) gene and that causes overlapping with polyarteritis nodosa (PAN) as a result of recessive mutations. ADA2 is both a major extracellular adenosine deaminase and an adenosine deaminase-related growth factor. In humans, the irreversible degradation of adenosine to inosine and deoxyadenosine to deoxyinosine is catalyzed by intracellular ADA1 and extracellular ADA2. 1 Recessive ADA1 mutations are a well-known cause of severe combined immune deficiency. However, ADA2 deficiency manifests as increased vascular inflammation without clinically apparent immune deficiency. This vasculopathy is characterized by highly varied age at onset, severity, and organ involvement, even within families and among patients with the same mutations. Manifestations range from severe or fatal systemic vasculitis or multiple strokes to limited cutaneous manifestations in children. 2 This disease encloses a wide spectrum of vascular and inflammatory manifestations, including earlyonset strokes, recurrent fevers, and systemic vasculopathy, which is often consistent with PAN. 3

Infections may trigger or aggravate glomerulonephritidis and renal vasculitis like Henoch Schonlein purpura (HSP). HSP is seen more frequently in patients with familial Mediterranean fever in which TLR-2 Arg753Gln polymorphism frequency is increased. Although renal involvement is the most important factor affecting the prognosis in HSP, it is not known which patients will have renal disease or why some patients have severe renal involvement while some others have mild renal disease. We investigated the role of TLR-2 and TLR-4 polymorphisms on the incidence and severity of renal involvement in HSP patients. We studied HSP patients with and without nephritis (n = 15 for each group) and healthy controls (n = 100). TLR-2 Arg753Gln and TLR-4 Asp299Gly/Thr399Ile polymorphisms were analyzed with polymerase chain reaction-restriction fragment length polymorphism method. The frequency of TLR-2 Arg753Gln, TLR-4 Asp299Gly, and Thr399Ile polymorphisms in healthy controls were 1, 3, and 2%, respectively. The frequencies of these polymorphisms were not different in HSP patients with or without nephritis compared to healthy controls. TLR-2 Arg753Gln, TLR-4 Asp299Gly, and Thr399Ile polymorphisms are not increased in HSP or HSP nephritis patients.

Immunoglobulin A nephropathy (IgAN) is associated with mucosal IgA defect. Probiotics regulate specific and innate immunity. We evaluated the effect of Saccharomyces boulardii on experimental IgAN in mice. Four groups of BALB/c mice (eight for each) were formed. Group 1 was immunized by oral poliovirus vaccine (OPV) at 0, 14, and 28 days. Group 2 was also given S. boulardii in addition to OPV. Group 3 was given only S. boulardii, whereas group 4 received no treatment. At week 6, after urine and serum samples were obtained for urinalysis and serum creatinine and IgA measurements, all animals were sacrificed to get their kidneys for histopathological evaluation. Urinalysis and serum creatinine levels were normal in all groups. Serum IgA level was increased only in group 1. Whereas group 1 had mesangial proliferation, histology was normal in the other groups. Predominant IgA deposition was universal in group 1, whereas it was either not present or minimal in other groups. Three mice in group 1 also had C3 deposition, which was absent in other groups. Electron microscopy revealed mesangial proliferation, matrix expansion, focal glomerular basement membrane thickening and electron-dense deposits in group 1 only, whereas the other groups were normal. In conclusion, enteral S. boulardii prevented OPV-induced IgAN in mice.

In conclusion, eculizumab may be a treatment of choice to prevent further systemic damage in recurrent HUS episodes of patients with borderline changes in the bone marrow until ALL is constantly diagnosed.