Aim: The aim of this study was to evaluate physical growth of very low birth weight (VLBW) preterm babies at a mean age of three years and to investigate the factors which affected growth. Material and Methods:The factors including maternal problems, prenatal problems, early neonatal problems, nutrition, familial socioeconomical status and presence of chronic disease which affected catch-up growth in terms of height and weight in VLBW infants followed up in the neonatal intensive care unit (NICU) of our hospital were examined. The target height formula was used in assessment of growht in height and the contribution of genetic properties was investigated. The points of the subjects on the growth curve were plotted according to the Percentile Curve of the Turkish Children prepared by Neyzi et al. The states of the subjects with and without intrauterine growth retardation (were compared. The study was intitiated after obtaining approval from the ethics committeee of our hospital (100/25.10.2005). Results:One hundred and seventeen preterm babies (57 females and 60 males) with a mean adjusted age of 35.8±2.39 80 of whom were appropriate for gestational age (AGA), 28 of whom were symmetrical (small gestational age) SGA and 9 of whom were asymmetrical SGA were included in the study. The mean gestational age (GA) was found to be 31±2.16 weeks and the mean birth weight (BW) was found to be 1271±226 g. The mean current height was found to be 92.06±4.90 cm. The mean weight was found to be 12.98±1.94 kg. The mean target height was calculated to be 163.66±8.1 cm (157.20 cm for the girls and 170.20 cm for the boys). It was found that 15 preterm babies (12.8%) could not achieve the target height (girls: 6%, boys: 6.8%). The risk factors related with failure to achieve target height were found to include ventilator treatment, presence of chronic disease, advanced stage intracranial bleeding (ICB), posthemorrhagic hydrocephalus, absence of breastfeeding, failure to sit at the table with the family and malnutrition. The maternal age, early rupture of membranes (PROM), preeclampsia, smoking, early neonatal problems, gender, being AGA and SGA, gestational age, birth weight and socioeconomical level were statistically insignificant in terms of achieving target height (p>0.05). Conclusions:If very low birth weight preterm babies have no chronic disease and condition leading to neurodevelopmental retardation and if they are breastfed early and continuously (0-24 months), they can achieve catch-up growth similar to term babies. In examination of growth in terms of height, using target height may be more appropriate to shown the genetic potential. (Türk Ped Arş 2014; 49: 289-98)
ÖZET Amaç: Guillain-Barre sendromu (GBS) tanısı alan hastaların e/ektrofizyolojik olarak saptanan subtip/eri ile prognostik özellikleri arasındaki ilişkinin araştırılması. Yöntem: Çalışmada 01.03.02 ve 31.12.04 tarihleri arasında hastanemiz çocuk nörolojisi servisinde GBS tanısıyla yatarak izlenen ve bir yıl süreyle poliklinik takibine gelen dokuz hasta değerlendirildi. Hastalar yaş, cinsiyet, başvuru şikayet/eri, geçirilmiş enfeksiyon varlığı, klinik bulgular, başvurudaki fonksiyonel durumları, BOS bulguları, tedaviye yanıt ve prognostik özellikler yönünden yatış ve po/iklinik takip dosyalarından retrospektif olarak incelendi. Akut dönemde tüm olgu/ara e/ektrofizyolojik çalışma uygulandı. Sinir ileti çalışmasında yüzey elektrod kaydı ile standart teknikler kullanılarak motor ve duysal sinir iletimi ve F dalga yanıtı değerlendirildi. Hastaların tümüne intravenöz immünglobulin 0.4 gram/lqi,qün olarak 5 gün süreyle verildi ve fonksiyonel durumları Hughes skalasına göre değerlendirildi. Bulgular: Dokuz GBS vakasının biri kız, sekizi erkekti. Hastaların yaş aralığı 2 ile 14 yıl (ortalama yaş 6.2) arasında değişmekteydi. Hastaların biri hariç hepsinde önceden geçirilmiş bir enfeksiyon öyküsü mevcuttu. Beyin omuri/ik sıvısı (BOS) incelemesinde albuminosito/ojik disosiasyona dört olguda rast/andı. Altı (%66) hastada AMAN subtipi saptanırken AIDP, AMSAN ve Miller Fisher sendromlu birer hasta mevcuttu. Dokuz olgunun sekizinde fonksiyonel tam iyileşme ortalama 3 ayda saptanırken AMAN subtip/i bir hastada ağır sekelli iyileşme izlendi. Sonuç: Hastaların çoğunluğunu gelişmekte olan ülkelerde daha sık rastlanılan subtip olan aksonaJ form oluştumaktaydı. Bu çalışmada kötü prognostik özellik gösterdiği bilinen aksonaJ formda erken tanı ve tedaviyle fonksiyonel olarak tam iyileşme görülebileceği kanısına varıldı. Anahtar Kelimeler: Guillain Barre sendromu, flask para/izi, intravenöz immunoglobulin, subtip, erken tedavi SUMMARY Aim: To investigate the re/ationship between the subtypes and prognostic features of the patients with Guillain Barre Syndrome (GBS). Methods: Between March 2002 and December 2004 nine children diagnosed as GBS and follQwed up for 1year were retrospectively evaulated for age, sex, complaints, history of previous infections, elinical and CSF findings, functional grade of motor deficits on admission, their response to treatment and prognostic features. Electrophysiological studies were performed at the acute phase to all pat'ients. Nerve conduction studies including motor nerve conduction, sensory nerve conduction and Fwave response studies wereperformed by the standart tecnique of surface e/ectrode recorcling. Standart intravenous immunoglobulin therapy was administered with a dose of 0.4 glkglday for fiuc consecutive days. The functiona/ grade of motor deficits was assessed according to the scale of Hughes.Results: There were 9 patients (mean age 2.6 years of age; range 2 to 14 years), inciueling one gir/ and eight boys. All patiens had history of preuious infection except for one patient. Albuminocytologi...
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