Lower maternal and neonatal 25-OHD levels are associated with EOS. These data suggest that adequate vitamin D supplementation during pregnancy may be helpful to prevent EOS in term neonates.

Objective:Cathelicidin is an important antimicrobial peptide in the urinary tract. Cathelicidin expression is strongly stimulated by 1,25-dihydroxy vitamin D in epithelial cells, macrophages/monocytes, and neutrophils. Vitamin D and cathelicidin status in children with urinary tract infection (UTI) caused by Escherichia coli is unknown. To establish the relationship between serum vitamin D and urine cathelicidin levels in children with a UTI caused by Escherichia coli.Methods:Serum 25-hydroxy vitamin D and urine cathelicidin levels were measured in 36 patients with UTI (mean age 6.8±3.6 years, range: 0.25-12.6 years) and 38 controls (mean age 6.3±2.8 years, range: 0.42-13 years).Results:There were no significant differences in urine cathelicidin levels between the study and control groups (p>0.05). Eight (22.2%) patients in the study group and 21 (58.3%) children in the control group were found to have sufficient vitamin D (≥20 ng/mL). Patients with sufficient vitamin D had higher urine cathelicidin levels than the controls with sufficient vitamin D (respectively 262.5±41.1 vs. 168±31.6 ng/mL, p=0.001). There were no significant differences between the patients and controls with insufficient vitamin D (p>0.05).Conclusion:The children with vitamin D insufficiency may not be able to increase their urine cathelicidin level during UTI caused by Escherichia coli. There is a need of prospective studies in order to prove a beneficial effect of vitamin D supplementation for the restoration of cathelicidin stimulation and consequently for prevention of UTI recurrence.

We demonstrated for the first time that lower maternal and neonatal vitamin 25-OHD levels were associated with BPD development in preterm infants. However, further studies with larger sample sizes are needed to delineate the possible link between vitamin D deficiency and BPD.

The aim of this study was to evaluate the predictive value of resistin and visfatin in neonatal sepsis, and to compare these adipocytokines with C-reactive protein (CRP), procalcitonin and interleukin 6 (IL-6). Donors and methods. A total of 62 term or near term infants with sepsis proven by positivity of blood culture, and 43 healthy infants were included in this study. Results. There were no statistically significant differences between the two groups as regards birthweight and gestational age. White blood cell count (p= 0.039), CRP levels (p=0.01), procalcitonin levels (p=0.01), IL-6 levels (p= 0.01), visfatin levels (p=0.01) and resistin levels (p=0.01) were significantly higher in septic infants. There was a positive correlation between visfatin, resistin and other markers (WBC, CRP, procalcitonin and IL-6). A cutoff value of 10 ng/mL for visfatin, showed 92% sensitivity and 94% specificity, and a cutoff value of 8 ng/mL for resistin showed 93% sensitivity and 95% specificity for neonatal sepsis. Conclusion. In the light of these results, visfatin and resistin can be used as a diagnostic marker similar to CRP, procalcitonin and IL-6 in neonatal sepsis. Further studies are needed to better understand the role and predictive value of these molecules in neonatal sepsis.

BackgroundThe quadriceps femoris muscle ruptures usually occur in the middle-aged population. We present a 4-year-old patient with partial rupture of the quadriceps femoris muscle. To our knowledge, this is the youngest patient reported with a quadriceps femoris muscle rupture.Case PresentationA 4-year-old girl admitted to our clinic with left knee pain and limitation in knee movements. Her father reported that she felt pain while jumping on sofa. There was no direct trauma to thigh or knee. We located a palpable soft tissue swelling at distal anterolateral side of thigh. The history revealed that 10 days ago the patient was treated for upper tract respiratory infection with intramuscular Clindamycin for 7 days. When we consulted the patient with her previous doctor and nurse, we learnt that multiple daily injections might be injected to same side of left thigh. MRI showed a partial tear of vastus lateralis muscle matching with the injection sites. The patient treated with long leg half-casting for three weeks. Clinical examination and knee flexion had good results with conservative treatment.ConclusionsMultiple intramuscular injections may contribute to damage muscles and make prone to tears with muscle contractions. Doctors and nurses must be cautious to inject from different parts of both thighs.

We suggested that the pathogenesis of ROP, which is regarded as a neovascular retinal disorder, includes variations in the levels of apelin and IGF-1.

Serum cTnI was increased even in LDD and parallel to it low cardiac injury induced by DXR. In the low-dose group, BNP and ET-1 levels were not elevated significant as cTnI despite cardiac injury. Thus, cTnI may be a predictive marker in of DXR-induced cardiotoxicity.

Despite major advances in intensive care, sepsis continues to be a major cause of morbidity and mortality. Vitamin D is involved in various physiologic functions, including cellular responses during infection and inflammation. The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D in childhood sepsis because it can be fatal if diagnosis delayed. The study included 40 children with sepsis and 20 children without sepsis (control group). We included only the patients with high probable sepsis, judged by clinical and laboratory findings, including positive blood culture. Blood samples were collected from patients with sepsis before treatment (pre-treatment group) and 48-72 hours later (post-treatment group). Treatment varied from ampicillin-sulbactam to cephalosporin. Blood samples were collected from control group once on admission. Serum 25-hydroxyvitamin D levels were significantly higher in sepsis (pre-treatment group) than control group (74 ± 8 ng/ml vs. 28 ± 12 ng/ml, p = 0.01) and the serum 25-hydroxyvitamin D levels were decreased to 44 ± 5 ng/ml (p = 0.01) after treatment. Moreover, we found significant positive correlation between 25-hydroxyvitamin D and each of well-know sepsis markers, C-reactive protein, tumor necrosis factor-α and interleukin-6. A cut-off point of 20 ng/mL for serum 25-hydroxyvitamin D showed 84% sensitivity and 76% specificity for sepsis diagnosis. This is the first study evaluating the diagnostic role of vitamin D in pediatric sepsis, thereby suggesting that serum 25-hydroxyvitamin D level can be used as a diagnostic marker for sepsis with high sensitivity and specificity.