M ultisystem inflammatory syndrome in children (MIS-C) guidance has been issued by the World Health Organization and by the Centers for Disease Control and Prevention. 1,2 Pediatric acute ischemic stroke and thromboembolic conditions have been reported as rare complications of COVID-19 or MIS-C. [3][4][5] Venous thromboembolism has not been reported in children with no underlying disease who have undergone enoxaparin prophylaxis after recovery from MIS-C. This previously healthy 9-year-old boy without any history of head trauma arrived at the hospital obtunded, nonverbal, with a left-sided hemiparesis and leftsided central facial paralysis. He had fever, nausea, vomiting, diarrhea, and tenesmus for 5 days. His parents had been ill with SARS-CoV-2 infection about a month prior.

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Objective: Adiponectin and its receptors are known to be expressed in osteoblasts and may have important functions in normal bone cells. The aim of this study was to investigate the effect of vitamin D therapy on serum adiponectin levels in children with vitamin D deficiency rickets (VDDR).Methods: 21 patients with VDDR were included in the study. Patients were treated with 300,000 U D3 (IM) and calcium lactate (50mg/kg/ day, PO, for 10 days). Anthropometric parameters and serum biochemical markers including calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), intact parathormone (iPTH), 25-hydroxyvitamin D (25(OH)D), and adiponectin levels were measured before and after one month of therapy. Results: Weight and length, but not BMI, increased significantly after treatment. Serum 25(OH)D level increased significantly after treatment, while serum adiponectin level decreased (4.21±1.84 vs 52.73±17.63 ng/ml, p<0.000; 150.1±66.14 vs 84.29±9.06 mg/ml, p<0.000, respectively). No significant correlations were found between serum adiponectin and 25(OH)D levels before and after treatment or between delta adiponectin concentrations and delta 25(OH)D levels.Conclusion: Serum adiponectin levels are increased in patients with VDDR, a finding which is probably related to increased osteoblastic activity.Conflict of interest:None declared.

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This study aims to investigate the protective effect of roflumilast, a phosphodiesterase (PDE)‐4 enzyme inhibitor, and demonstrate its possible role in the development prevention of cerebral ischemia/reperfusion injury (CI/RI) after stroke induced by carotid artery ligation in juvenile rats. The rats were randomly divided into five groups: healthy group without any treatment, healthy group administered with 1 mg/kg roflumilast, CI group not administered with roflumilast, CI group administered with 0.5 mg/kg roflumilast, and CI group administered with 1 mg/kg roflumilast. In the CI groups, reperfusion was achieved 2h after ischemia induction; in the roflumilast groups, this drug was intraperitoneally administered immediately after reperfusion and at the 12th hour. At the end of 24h, the rats were sacrificed and their brain tissues removed for examination. The mRNA expressions obtained with real‐time PCR of IL‐1β, TNF‐α, and NLRP3 significantly increased in the CI/RI‐induced groups compared with the control group, and this increase was significantly lower in the groups administered with roflumilast compared with the CI/RI‐induced groups. Moreover, ELISA revealed that both IL‐1 β and IL‐6 brain levels were significantly higher in the CI/RI‐induced groups than in the controls. This increase was significantly lower in the groups administered with roflumilast compared with the CI/RI‐induced groups. Histopathological studies revealed that the values closest to those of the healthy group were obtained from the roflumilast groups. Nissl staining revealed that the Nissl bodies manifested normal density in the healthy and roflumilast‐administered healthy groups, but were rare in the CI/RI‐induced groups. Roflumilast treatment increased these decreased Nissl bodies with increasing doses. Observations indicated that the Nissl body density was close to the value in the healthy group in the CI/RI‐induced group administered with 1 mg/kg roflumilast. Overall, roflumilast reduced cellular damage caused by CI/RI in juvenile rats, and this effect may be mediated by NLRP3.

Introduction:There is no regional study presenting the pediatric intoxication cases followed in pediatric intensive care units (PICUs). As they show regional features, we aimed to present the pediatric intoxication cases followed in our PICU, and indicate our self-constituted protocol about the PICU admission rules in these patients. Methods:Demographic, clinical and laboratory data of patients who admitted with intoxication and followed in PICU between October 2015 and October 2017 were noted. PICU admission indications were evaluated.Results: Twenty-four (14%) of the 171 intoxication cases formed the study group. Fourteen (58.3%) were female. Ten cases (41.7%) were under 5 years old, 6 (20.8%) were 5-12 years and 8 (37.5%) were over 12 years. In first group, all intoxications were by accident. In second, intoxications were due to accident (n=3), during drug use in treatment dose (n=2) and as a result of child abuse (n=1). In last group, it was by accident in 2, but as a result of suicide in 6 cases. Active ingredients were; central nervous system drugs (n=9), plant (atropa belladona) (n=3), decongestant drugs (n=3), multiple drugs (n=4), intoxication by inhalation (n=1) and other drugs (n=4). Fifteen patients (62.5%) had clinical indications for PICU admission. In five (20.8%) the poison control center advised PICU admission. In four patients (16.7%) we decided PICU admission because of the fatal nature of the ingested drugs. Conclusion:Our results suggest that every clinic, by taking their availabilities into account, should form its own protocols for PICU admission for pediatric intoxication cases.Giriş: Bölgemizde çocuk yoğun bakım ünitesinde (ÇYBÜ) izlenen çocuk zehirlenme olgularının sonuçlarını gösteren bir çalışma bulunmamaktadır. Bölgesel özellikler gösterdiğinden ÇYBÜ'de izlenen zehirlenme olgularını sunmayı ve bu hastalarda ÇYBÜ kabul kuralları hakkındaki kendiliğinden oluşan protokolü sunmayı amaçladık.Yöntemler: Ekim 2015-Ekim 2017 tarihleri arasında çocuk acil kliniğine başvuran zehirlenme olgularından ÇYBÜ'ye yatırılanların demografik, klinik ve laboratuvar verileri hastane tıbbi kayıt sisteminden elde edildi. Hastalar ÇYBÜ'ye kabul gerekçeleri yönünden değerlendirildi.Bulgular: Çocuk acil polikliniğine başvuran ve intoksikasyon tanısı alan 171 hastanın 24'ü (%14) çalışma gurubunu oluşturdu. Hastaların 14'ü (%58,3) kız çocuktu. Onu (%41,7) 5 yaş altında, altısı (%20,8) 5-12 yaş arasında ve sekizi (%37,5) 12 yaş üstündeydi. Beş yaş altındaki zehirlenmelerin tamamı kazara alınan ilaçlar sonucunda oluşmuşken, 5-12 yaş grubunda 3 olgu kazara alım, 2 olgu tedavi dozunda ilaç kullanımı ve bir olgu istismar sonucu oluşmuştu. On iki yaş üzerindeki hastaların 6'sı özkıyım amaçlı ilaç alımıyla ve 2'si kazara zehirlenmişti. Etken maddeye göre gruplandırma yapıldığında zehirlenmelerden sorumlu maddeler aşağıdaki gibi idi; santral sinir sistemi ilaçları (n=9), bitki (n=3), dekonjestan ilaçlar (n=3), çoğul ilaç (n=4), inhalasyon zehirlenmesi (n=1), diğer ilaçlar (n=4). Klinik olarak yoğun bakım gereksinimi olan...

The study area is located in the Eastern Pontides between Rize, Çayeli, Arhavi, İspir and İkizdere. In this area, Maçka Tectonic Slice (MTS) and Taşköprü Tectonic Slice (TTS) are exposed. MTS is composed from old to young; Late Jurassic-Early Cretaceous limestone (Berdiga fm.); Turonian-Santonian conglomerate, sandstone, micritic limestone, siltstone, marl, basaltic, basaltic-andesitic lava, pyroclastites (Çatak fm.); Santonian rhyolitic, dacitic lava, pyroclastites, sandstone, clayey limestone (Kızılkaya fm.); late Santonian-Campanian basaltic, andesitic lava, pyroclastites, sandstone, clayey limestone (Cağlayan fm.); Campanian-Mastrihtian rhyolitic, dacitic lava, pyroclastites, sandstone, clayey limestone (Çayırbağ fm.);late Maastrichtian-Danian sandstone, claystone, tuff, marl, clayey limestone (Cankurtaran fm.). Sedimentary, volcanosedimentary units in the Late Paleocene-Quaternary range (Erenler, Kaplıca, Melyat, Pazar, Hamidiye formations, and Handüzü, Çağırankaya volcanites) unconformably overlies the MTS. In the study area, Turonian-Maastrichtian basaltic andesitic lavaş, pyroclastites and sandstone, micritic limestone, claystone units (Yağmurdere fm.) belonging to TTS are observed, and Early-Middle Eocene sedimentary and volcanosedimentary units (Yedigöze, Çoruh formations) unconformably overlies the TTS. According to Ar/Ar dating, Çayırbağ formation was determined as 83.2 ± 1.0 Ma, Melyat formation as 47.8 ± 1.6 Ma, and Handüzü volcanics as 4.25 ± 0.55 Ma for andesite level and as 3.93 ± 0.46 Ma for dacite level. The MTS was intruded by Cretaceous-Paleocene Kaçkar granitoid I, Eocene Kaçkar granitoid II, Late Eocene Ardeşen gabbro, while the TTS was intruded by Cretaceous-Paleocene Kaçkar granitoid-I, Late Eocene Güllübağ monzonite.

Hydrocephalus is a rare complication of mumps. We report an 8.5-year-old boy with acute hydrocephalus associated with mumps meningoencephalitis.