Although to be prevalence of onychomycosis in school children in central Anatolia of Turkey seems very low degree, pediatric onychomycosis is a growing public health concern all over the world. Children having more siblings or unemployed fathers and children living in small house as well as older children should be examined carefully for onychomycosis.

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.

Aim: To examine children who present with enlargement of lymph nodes in terms of demographic, clinical, serological and radiological aspects. Material and Methods:Ninety-eight patients who presented with a complaint of enlargement of lymph nodes were examined in terms of demographic, clinical, serological and radiological aspects by screening file data retrospectively. The character of lymph nodes (reactive, malign) was evaluated according to the distribution, number, sizes and blood supply determined in ultrasonographic measurements. Fisher's Exact test and Mann-Whitney U Test were used in comparison of the groups. Kappa value was used in assessment of compatibility between the two groups.Results: Cervical lymphadenomegaly was found most frequently in accordance with the complaint of swelling in the neck. Erythrocyte sedimentation rate, ultrasonography, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) IgM were not found to be statistically significatly different between the normal and abnormal physical examination groups (erythrocyte sedimentation rate; p=0.623, USG; p=0.753, EBV and CMV; p=1.00). Cytomegalovirus and EBV IgM were not found to be statistically significatly different between the normal and abnormal ultrasonography groups (CMV; p=0.35, EBV; p=0.36). There was no compatibility between physical examination and ultrasonography (=0.32). Conclusion:Lymphadenopathy is a common problem in the childhood and necessitates a careful physical examination and follow-up. Laboratory and imaging methods should be used when necessary. Although lymphadenopathy is mostly related with infections, care should be taken in terms of malignancy and malignancy should be eliminated. The important point is systemic evaluation and follow-up of the patient. It is important to note physical examination findings and clinical follow-up findings, because frequent ultrasonographic investigations may confuse physicians and families with high values of lymph node measurements despite normal physical examination. Therefore, using our fingertips with a good physical examination is still our most sensitive diagnostic tool instead of ultrasonography. (Türk Ped Arş 2014; 49: 30-5)

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We found etanercept treatment to be protective in newborn rats with hyperoxia-induced lung damage.

We read with interest the article by Alharazy et al 1 concerning the early diagnosis of acute kidney injury (AKI) after using contrast medium. Contrast-induced nephropathy (CIN) is the third most common cause of AKI in hospitalized patients (11% of the cases). 1 Early diagnosis is vital because prevention is possible. There are new serum markers for the early diagnose of CIN. 2 Among these, Alharazy et al 1 demonstrated that serum neutrophil gelatinase-associated lipocalin was an early biomarker of CIN in patients with chronic kidney disease undergoing coronary catheterization.Renal insufficiency is associated with many diseases including acute myocardial infarction. 3 Because of that, preventive treatments are important. In the study of Alharazy et al, 1 despite preventive measures, the frequency of CIN was 11%, similar to that reported by others. 2,4 A number of methods have been used to prevent CIN. Alharazy et al 1 administered intravenous normal saline and oral N-acetylcysteine. Among preventive treatments of CIN, alkalinization of urine has an important place. Sodium or potassium citrate is a well-known agent for urine alkalinization, but unfortunately, it may not be commonly used. It has been reported that patients with a urine pH < 6 had a >10-fold higher risk of CIN compared with patients whose urine pH was >6. 5 Gene polymorphisms may play a role in CIN development. Gene polymorphisms of interleukin 10 and tumor necrosis factor-a were found to be associated with CIN development. 6 Alharazy et al 1 demonstrated that patients of Indian ethnicity are predisposed to CIN. We suggest that gene polymorphisms may play a role in this predisposition. Prospective cohort studies should evaluate this potential relationship.

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