OBJECTIVE: Acute mastoiditis is serious otological condition which may cause difficult, sometimes fatal complications. The aim of the study is to present our experiences in diagnosis and treatment of acute mastoiditis in children.
MATERIALS and METHODS:Medical records of 52 children with diagnosis of acute mastoiditis were reviewed retrospectively. Data on clinical presentation, laboratory tests, microbiological and radiological features, prehospital treatment and delay in making the diagnosis, hospital treatment and outcome were analyzed. A relationship between white blood cell count or level of C-reactive protein and therapeutic protocols was investigated.
RESULTS:All children were admitted as emergency patients and were treated with intravenous antibiotics. Almost 15% of patients were not examined by a doctor prior to hospitalization. The conservative treatment was successfully conducted in 15% of patients. One-third of the patients were recovered after myringotomy. Almost a half of the patients underwent surgical procedure such as antrotomy, mastoidectomy or tympanomastoidectomy. Computed tomography (CT) scan was done in patients with signs of developing complications and those with no improvement after the beginning of treatment.
CONCLUSION:Acute mastoiditis is still persisting problem in our health care system. An early diagnosis and adequate treatment of acute mastoiditis is essential in order to prevent serious complications.
AIM: Intracranial aneurysm rupture is followed by high mortality and morbidity. In order to understand the aneurysm's natural course, it is necessary to recognize the predisposing factors for the rupture.
ResULTs:The ratio between the width of the aneurysm neck and diameter of the carrying blood vessel -artery in ruptured aneurysms (OR) was 1.58±0.61, and in unruptured aneurysms 1.14±0.52 (p<0.01). Aspect ratio of ruptured aneurysm was 1.89 ± 0.59, and in unruptured 1:33 ± 0.17. The angle of inclination of ruptured aneurysms was 139.22 ± 21.53, while in unruptured aneurysms it was 101.73 ± 21.26.
CoNCLUsIoN:Based on the results of our research, a predictive model of morphometric characteristics of the vessel bearing the aneurysm to rupture can be identified: an irregular shape of the aneurysm, AR> 1.6, OR> 1.5 and inclination angle >135 deg. soNUÇ: Araştırmamızın sonuçları temelinde rüptüre olacak anevrizmayı taşıyan damarın morfometrik özelliklerinin prediktif bir modeli tanımlanabilir: Anevrizmada düzensiz şekil, aspekt oranı >1,6, OR >1,5 ve inklinasyon açısı >135 derece.
Spondylocostal dysostosis is a very rare combination of complex vertebra and rib malformations, accompanied occasionally by other disorders. A 3-year-old girl presented kyphoscoliosis, foot deformities, gate disturbance, and urinary incontinence. The CT and MRI examination revealed kyphosis and scoliosis with a double curve, some absent, broadened, bifurcating and fused ribs, hemivertebrae, butterfly and cleft vertebrae in thoracic and lumbar region, sporadic cleft or absent vertebral arches or pedicles, and hypoplastic sacrum with a cleft of the S2 vertebra. Spina bifida occulta extended from T10 to T11, and from L3 to the end of the sacrum. Two hemicords, separated by a bony septum and surrounded by their own dural tubes (type I), were present from the level of T9 to the conus medullaris. Filum terminale was thick and duplicated. Syringomyelia was present in the thoracic cord from T5 to T8. Finally, a small meningocele was seen at the T10–T11 level, and a subcutaneous lipoma in the thoracolumbar region. To our knowledge, such a combination of vertebra, rib, and cord malformations, including the mentioned additional disorders, has never been reported.
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