Background Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. Methods The... more
Background Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. Methods The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre. Results A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarr...
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Sözüer, Ö., Yılmaz, T., Berberoğlu, E., Aktay, L., Kızılkaya, E., 2014. Göller Bölgesi Kış Ortası Su Kuşu Sayımı 2013 Sonuç Raporu, T.C. Orman ve Su İşleri Bakanlığı, Doğa Koruma ve Milli Parklar Genel Müdürlüğü VI. Bölge Müdürlüğü,... more
Sözüer, Ö., Yılmaz, T., Berberoğlu, E., Aktay, L., Kızılkaya, E., 2014. Göller Bölgesi Kış Ortası Su Kuşu Sayımı 2013 Sonuç Raporu, T.C. Orman ve Su İşleri Bakanlığı, Doğa Koruma ve Milli Parklar Genel Müdürlüğü VI. Bölge Müdürlüğü, Burdur, Türkiye.
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Abstract: This is one of the first studies delineating some characteristic features of certain common childhood problems of pediatric cerebral palsy (CP) subjects that might have been overlooked in previous medical visits. We collected... more
Abstract: This is one of the first studies delineating some characteristic features of certain common childhood problems of pediatric cerebral palsy (CP) subjects that might have been overlooked in previous medical visits. We collected data on immunization and also blood, urine and stool specimens of 89 CP subjects and 80 control patients. The CP subjects had significantly higher ratios of anemia, urinary tract infections and missed shots of immunization than patients presenting with first seizure as control group (pl0.05 for each). There was no difference in ratio of intestinal parasites but was quite high in both groups (18%). It will afford a good opportunity for CP subjects if pediatric neurologists, who regularly follow up these patients, focus on some non-neurological but common childhood problems as well. Key words: Cerebral Palsy; Urinary Tract Infection; Anemia; Missed Immunization Shots; Intestinal Parasites.
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Objective: We aimed to determine the ratio of antiHBs seropositivity in patients aged between 0 16 years who were admitted to the Department of Pediatrics of a university hospital in Eastern Anatolia In addition we wanted to show if there... more
Objective: We aimed to determine the ratio of antiHBs seropositivity in patients aged between 0 16 years who were admitted to the Department of Pediatrics of a university hospital in Eastern Anatolia In addition we wanted to show if there is any difference in children who were born after implementation of hepatitis B vaccine into national immunization programme Material and Method: We studied 989 subjects aged 2 months 16 years who were admitted to our Department between 2004 January and 2005 July We used x2 test to evaluate the serological results Results: There is statistically significant decrease of antiHBs seropositivity with increasing age x2: 72 8 p lt;0 00001 On the contrary there is significant increase in ratio of antiHBc IgG seropositivity with increasing age x2: 27 2 p lt;0 0001 Conclusions: The ratio of antiHBs seropositivity is increasing in subjects born after implementation of hepatitis B vaccine into national immunization scheme though not reached to targeted level ...
Research Interests: Medicine and Immunization
It is well known that the most traditional method of swaddling the neonates is laying them onto the heated soil entitled as “holluk” in Anatolia for centuries. Some parts of Anatolia which have lower socioeconomic values still maintain... more
It is well known that the most traditional method of swaddling the neonates is laying them onto the heated soil entitled as “holluk” in Anatolia for centuries. Some parts of Anatolia which have lower socioeconomic values still maintain this traditional method. We, herewith, would like to present 3 neonates who were swaddled via “holluk” and admitted to our hospital with different infectious diseases. Two of the neonates died because of tetanus infection and Eschericia coli septic shock. Key words: Holluk, Tetanus infection
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Research Interests: Biology and Salmonella
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Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with... more
Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition. This report, as a part of the prospective national pediatric varicella hospitalizations study (including 29 centers, represent 50% of pediatric population) in Turkey, is aimed to evaluate breakthrough varicella infection requiring hospitalization before the routine use of single-dose live varicella vaccine in national program from 2008 to 2013 (<10% of the pediatric age group received a single-dose vaccine). In the time period, 1939 children were hospitalized due to varicella infection in Turkey; 36 children (20 boys, 16 girls, mean age 68.0+37.6 months, all received single dose live varicella vaccine) with breakthrough varicella infection. Breakthrough varicella infection might be severe in previously healthy children (61...
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Objective Our study evaluates the epidemiological and demographics of the children who were admitted to Süleyman Demirel University, Medical Faculty, Paediatrics Department with the pre-diagnosis of pandemic influenza. Methods and... more
Objective Our study evaluates the epidemiological and demographics of the children who were admitted to Süleyman Demirel University, Medical Faculty, Paediatrics Department with the pre-diagnosis of pandemic influenza. Methods and Materials Demographic characteristics, clinical findings, laboratory tests results and radiological researchs of 64 patients (n = 64), who were admitted to Süleyman Demirel University, Medical Faculty Paediatric Department with the pre-diagnosis of pandemic influenza were analysed and evaluated. Results Average age of the patients, that were admitted and observed with pre-diagnosis of pandemical influenza, was 32.4 months (1–188 months) and 34% (n = 22) of the cases were female. H1N1v diagnosis was confirmed in 14% (n = 9) of the patients with pre-diagnosis of pandemiz influenza. Most common complaints during submission were severe cough (85.9%), fever (68.8%) and weakness (57.8%). Among the the patients who were H1N1v positive, 55% (n = 5) of them, had preexisting diseases. Five patients needed intensive care during the observation and treatment. Two (22.2%) of them did not survive. Conclusion Clinical findings of pandemical influenza and seasonal influenza are quite similar in children. Pre-existing diseases increase the rates of morbidity and mortality.
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There are numerorus published and ongoing experimental/clinical studies about probiotics and prebiotics, intestinal microbiota and nutrition. Three years ago, at the first International Symposium of Probiotics Prebiotics in Paediatrics in... more
There are numerorus published and ongoing experimental/clinical studies about probiotics and prebiotics, intestinal microbiota and nutrition. Three years ago, at the first International Symposium of Probiotics Prebiotics in Paediatrics in Istanbul (2012) we highlighted the 'paediatric perspective' on these issues and brought together more than 40 global key opinion leaders and 400 attendants to have a chance to extensively discuss the past, present and the future. In 2014, the second state of art congress, held in Antalya, aimed to discuss the gut microbiota and microbiotics and their impact through lifespan. Selected papers of this conference are presented in this special issue 'prebiotics and probiotics in paediatrics' of Beneficial Microbes. A summary of the conference results is provided below.
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... Erkan riz, Dilek Erer, Pnar Köksal, rfan Taflo¤lu, Volkan Sinci, Mehmet Emin Özdo¤an Gazi Üniversitesi, Tp ... Cemflit Karakurt , Gülendam Koçak , Ayfle Selimo¤lu*, Metehan Özen** From Units of Pediatric Cardiology, *Pediatric... more
... Erkan riz, Dilek Erer, Pnar Köksal, rfan Taflo¤lu, Volkan Sinci, Mehmet Emin Özdo¤an Gazi Üniversitesi, Tp ... Cemflit Karakurt , Gülendam Koçak , Ayfle Selimo¤lu*, Metehan Özen** From Units of Pediatric Cardiology, *Pediatric Gastroenterology and ** Pediatric Infectious ...
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ÖZET Amaç: Ge niş le miş spek trum lu be ta-lak ta maz üre ten Kleb si el la pne u mo ni a e in fek si yon la rı, te da vi de kul la nı lan an ti bi yo tik le rin se çi min de zor luk la ra ne den ol mak ta dır. Bu ça lış ma da, has ta ne... more
ÖZET Amaç: Ge niş le miş spek trum lu be ta-lak ta maz üre ten Kleb si el la pne u mo ni a e in fek si yon la rı, te da vi de kul la nı lan an ti bi yo tik le rin se çi min de zor luk la ra ne den ol mak ta dır. Bu ça lış ma da, has ta ne miz de izo le edi len ve ge niş le miş spek trum lu be ta-lak ta maz (GSBL) üre ten K. pne u mo ni a e suş la rın da CTX-M ti pi be ta-lak ta maz sık lı ğı, an ti bi yo tik di renç ve ko-re zis tans oran la rı araş tı rıl mış tır. Ge reç ve Yön tem ler: 2007 yı lın da çe şit li kli nik ör nek ler den izo le edi len top lam 107 K. pne u mo ni a e su şu ça lış ma ya dâhil edil miş tir. An ti bi yo tik du yar lı lık tes ti Cli ni cal and La bo ra tory Stan dards Ins ti tu te (CLSI)’nın öne ri le ri doğ rul tu sun da disk di füz yon yön te mi ile ya pıl mış tır. GSBL üre ti mi nin sap tan ma sın da çift disk si ner ji tes ti kul la nıl mış tır. Kar ba pe ne maz üre ti mi Mo di fi ye Hod ge tes ti ile be lir len miş tir. CTX-M ti pi be ta-lak ta maz la ra ait ge nin var lı ğı bu böl ge le re öz gül pri mer ler kul la nı la rak polimeraz zincir reaksiyonu yön te mi ile araş tı rıl mış tır. Bul gu lar: CTX-M ti pi be ta-lak ta maz sık lı ğı %85 ora nın da sap tan mış tır. Suş la rın ge nel ola rak ko-tri mok sa zo le (SXT) %79, am pi si linsul bak ta ma (SAM) %77, amok si si lin-kla vu la nik asi te (AMC) %68 ve nit ro fu ran to i ne (NIT) %52 gi bi ol duk ça yük sek oran lar da, ami ka si ne (AK) %19, sip rof lok sa si ne (CIP) %21, norf lok sa si ne (NOR) %24, gen ta mi si ne (GN) %31, se fo pe ra zon-sul bak ta ma (SCF) %32 ve pi pe ra si lin-ta zo bak ta ma (TZP) %37 gi bi da ha dü şük oran lar da di renç gös ter dik le ri be lir len miş tir. Suş la ra en et ki li an ti bi yo tik ler den me ro pe ne me (MEM) ve fos fo mi si ne (FOS) sı ra sıy la %2 ve %3 ora nın da di renç sap tan mış, imi pe nem di ren ci ne rast lan ma mış tır. Suş la rın %90’ın da ko-re zis tans sap tan mış, en yay gın iki ko-re zis tans fe no ti pi nin AMC/SAM/SXT/NIT (%9) ve AMC/SAM/SXT (%6.5) ol du ğu be lir len miş tir. So nuç: CTX-M ti pi be ta-lak ta maz la rın K. pne u mo ni a e suş la rın da ol duk ça yük sek oran lar da bu lun du ğu sap tan mış tır. GSBL üre ten K. pne u mo ni a e suş la rın da SXT, SAM, AMC ve NIT di ren ci nin yük sek bu lun du ğu böl ge miz de bu an ti bi yo tik ler le baş la nan am pi rik te da vi nin ye ter siz ka la bi le ce ği so nu cu na va rıl mış tır.
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Research Interests: Probiotics, Incidence Geometry, Medicine, Prevention, Humans, and 13 moreChild, Lactobacillus, Incidence, Systematic review, Probiotic, Randomized Controlled Trial, Respiratory Tract Infections, Intensive Care Medicine, Primary Prevention, Bifidobacterium, Randomized Controlled Trials as Topic, Adverse effect, and Medical and Health Sciences
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Research Interests: Turkey, Public Health, Adolescent, Medicine, Serology, and 15 morePregnancy, Population, Humans, Female, Rubella Virus, Middle Aged, Adult, Public health systems and services research, Pregnant Women, Elsevier, Seroprevalence, Cross Sectional Studies, Socioeconomic Factors, rubella vaccine, and Congenital Rubella Syndrome
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Objective:To report epidemiologic, bacteriologic, and clinical features of aChryseobacterium meningosepticumoutbreak.Design:Outbreak investigation.Setting:A neonatal intensive care unit (NICU) of a referral teaching... more
Objective:To report epidemiologic, bacteriologic, and clinical features of aChryseobacterium meningosepticumoutbreak.Design:Outbreak investigation.Setting:A neonatal intensive care unit (NICU) of a referral teaching hospital.Methods:During 2 weeks in September 2001, four neonates in the NICU developed sepsis and underwent laboratory investigation. Multiple samples were obtained for cultures from endotracheal tubes, mechanical ventilators and humidifier boxes, infant incubators, parenteral and antiseptic solutions, feeding bottles, sinks, faucets, doors, and healthcare workers.Results:C. meningosepticumwas isolated from the blood cultures of four patients. The first isolate was identified 5 days after the death of the index case. Although all isolates were ciprofloxacin susceptible in vitro, the remaining three patients did not respond to ciprofloxacin therapy given for 6 or 7 days. Therapy was switched to vancomycin and rifampin and all three patients survived, with one having a com...
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Research Interests: Hematology, Epidemiology, Incidence Geometry, Medicine, Humans, and 10 moreChild, Chemoprevention, Clinical Sciences, Immunocompromised host, Antifungal Agents, Intensive Care Medicine, Aspergillosis, Paediatrics and reproductive medicine, Pharmacology and pharmaceutical sciences, and Hematologic neoplasms
Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of children with severe malaria, particularly that caused by Plasmodium falciparum. We report a unique case of... more
Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of children with severe malaria, particularly that caused by Plasmodium falciparum. We report a unique case of P. vivax infection complicated by status epilepticus. A 4-year-old boy was admitted to the emergency outpatient clinic with intractable seizures for the previous hour. During resuscitation, two episodes of left-focal tonic convulsions occurred and he received phenytoin. Because of a history of P. vivax infection in the family 3 months previously, a blood slide for malaria was undertaken. Thin blood smears demonstrated P. vivax. He was treated with chloroquine and primaquine. An initial EEG was normal but after 3 months of follow-up a second EEG showed generalised epileptic activity. Rarely, cerebral malaria is a presenting complication or occurs during the course of P. vivax infection. In endemic areas such as Turkey, the possibility of cerebral malaria should be considered.
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Breastfeeding provides the ideal nutrition for infants. Human milk contains a plethora of functional ingredients which foster the development of the immune system. The human milk microbiota predominantly contributes to this protective... more
Breastfeeding provides the ideal nutrition for infants. Human milk contains a plethora of functional ingredients which foster the development of the immune system. The human milk microbiota predominantly contributes to this protective effect. This is mediated by various mechanisms, such as an antimicrobial effect, pathogen exclusion and barrier integrity, beneficial effects on the gastrointestinal microbiota, vitamin synthesis, immunity enhancement, secreted probiotic factors, and postbiotic mechanisms. Therefore, human milk is a good source for isolating probiotics for infants who cannot be exclusively breastfed. One such probiotic which was isolated from human milk is Limosilactobacillus fermentum CECT5716. In this review, we give an overview of available interventional studies using Limosilactobacillus fermentum CECT5716 and summarise preclinical trials in several animal models of different pathologies, which have given first insights into its mechanisms of action. We present sev...
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Background: Infantile colic has a multifactorial etiology; although various treatments have been attempted to manage and alleviate its symptoms, a solution is lacking, adversely affecting mothers and their babies. Recent studies have... more
Background: Infantile colic has a multifactorial etiology; although various treatments have been attempted to manage and alleviate its symptoms, a solution is lacking, adversely affecting mothers and their babies. Recent studies have suggested that dysbiosis may play a role in the pathogenesis of infantile colic and that modulating the gut microbiota, including the use of probiotics, may aid its management.Purpose: This single-blind randomized controlled study evaluated the effect of probiotics (Actiregularis, 5×106) added to the diet of mothers on infantile colic symptoms and neonatal gut microbiota content.Methods: A probiotic drink containing the Actiregularis (5× 106) strain was added to the diet of mothers in the experimental group once daily for 15 consecutive days. Stool samples were collected from each infant twice, on days 0 and 15, and fecal 16s rRNA gene sequencing and compositional-based metabolomic analyses were performed. The mothers recorded the babies’ crying frequen...
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The aim of this point prevalence study was to evaluate the consumption, indications and strategies of antifungal therapy within pediatric population in Turkey. A point prevalence study was performed at 25 hospitals. In addition to general... more
The aim of this point prevalence study was to evaluate the consumption, indications and strategies of antifungal therapy within pediatric population in Turkey. A point prevalence study was performed at 25 hospitals. In addition to general data on pediatric units of the institutes, the generic name and indication of antifungal drugs, presence of fungal isolation and susceptibility patterns, presence of galactomannan test and high-resolution computerized tomography (HRCT) scan results were reviewed. A total of 3338 hospitalized patients were evaluated. The number of antifungal drugs prescribed was 314 (9.01%). The antifungal drugs were mostly prescribed in PHO units (35.2%), followed by NICU (19.6%), pediatric services (18.3%), PICU (14.6%), and HSCT units (7.3%). Antifungals were used for prophylaxis in 147 (48.8%) and for treatment in 154 (51.2%) of the patients. The treatment strategies were empirical in 77 (52.3%), diagnostic-driven in 29 (19.7%), and targeted therapy in 48 (32.6%...
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Gut microbiota is closely related to acute infectious diarrhea, one of the leading causes of mortality and morbidity in children worldwide. Understanding the dynamics of the recovery from this disease is of clinical interest. This work... more
Gut microbiota is closely related to acute infectious diarrhea, one of the leading causes of mortality and morbidity in children worldwide. Understanding the dynamics of the recovery from this disease is of clinical interest. This work aims to correlate the dynamics of gut microbiota with the evolution of children who were suffering from acute infectious diarrhea caused by a rotavirus, and their recovery after the administration of a probiotic, CNCM I-745. The experiment involved 10 children with acute infectious diarrhea caused by a rotavirus, and six healthy children, all aged between 3 and 4 years. The children who suffered the rotavirus infection received CNCM I-745 twice daily for the first 5 days of the experiment. Fecal samples were collected from each participant at 0, 3, 5, 10, and 30 days after probiotic administration. Microbial composition was characterized by 16S rRNA gene sequencing. Alpha and beta diversity were calculated, along with dynamical analysis based on Taylo...
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Controlled trials concerning adjuvant dexamethasone therapy in bacterial meningitis do not point unequivocally to a beneficial effect on hearing ability. We investigated the remote adverse outcomes of pneumococcal meningitis and, if any,... more
Controlled trials concerning adjuvant dexamethasone therapy in bacterial meningitis do not point unequivocally to a beneficial effect on hearing ability. We investigated the remote adverse outcomes of pneumococcal meningitis and, if any, beneficial effects of adjuvant dexamethasone therapy on hearing ability. Fifty-five subjects who experienced pneumococcal meningitis between 1987-97 were divided into two groups as 25 subjects who did not receive dexamethasone (Group 1) and the remaining 30 subjects who did (Group 2). All subjects underwent pure tone thresholds estimation. There were a total of 11 subjects (20%) with sensorineural hearing impairment (SNHI): 6 in the first group (24%) and 5 in the second group (16%). Although there was no statistically significant difference in the SNHI ratio between the groups, all the subjects who used adjuvant dexamethasone therapy suffered only minimal-borderline SNHI, whereas 2 patients in Group 1 had moderate-serious SNHI. Even though adjuvant ...
Research Interests: Treatment Outcome, Adolescent, Medicine, Streptococcus pneumoniae, Dexamethasone, and 13 moreHumans, Child, TURKISH, Follow-up studies, Anti-inflammatory agents, Adult, Meningitis, Hearing Impaired, Long Term Effect, Adjuvant, Severity of Illness Index, Child preschool, and Paediatrics and reproductive medicine
Mumps is still one of the most common childhood diseases in areas where national immunization has not been implemented. Although central nervous system manifestation is not so uncommon, hydrocephalus secondary to mumps is very rare. In... more
Mumps is still one of the most common childhood diseases in areas where national immunization has not been implemented. Although central nervous system manifestation is not so uncommon, hydrocephalus secondary to mumps is very rare. In this report, we present a toddler who developed severe hydrocephalus during mumps infection, which resolved via timely cerebral spinal fluid (CSF) drainage. We would like to emphasize early intervention for CSF external drainage.
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A 50-day-old girl with swelling and ecchymosis of right hand dorsum after DTP vaccination on ipsilateral deltoid area was referred to the pediatric infectious disease outpatient unit with a presumed diagnosis of gangrenous cellulites.... more
A 50-day-old girl with swelling and ecchymosis of right hand dorsum after DTP vaccination on ipsilateral deltoid area was referred to the pediatric infectious disease outpatient unit with a presumed diagnosis of gangrenous cellulites. Physical examination and laboratory evaluation revealed intramuscular bleeding as a result of vitamin K deficiency. We would like to emphasize the importance of both vitamin K prophylaxis in the newborn to prevent hemorrhagic disease of the newborn and of the education of persons administering vaccines about this very basic aspect of pediatrics for early recognition.
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A retrospective review was conducted on 132 patients aged between two and 15 years with cervical lymphadenitis and/or with abscess formation to determine the epidemiologic and clinical presentation of these infections. The most common... more
A retrospective review was conducted on 132 patients aged between two and 15 years with cervical lymphadenitis and/or with abscess formation to determine the epidemiologic and clinical presentation of these infections. The most common locations were the upper anterior cervical space (43.2%) and the submandibular space (27.3%). The duration of symptoms ranged from 12 hours to 20 days. Results of the pus cultures were available in 31 patients (23.5%). Of these, 16 cultures (51.6%) were positive. The isolated organisms were Staphylococcus aureus (50%), Staphylococcus epidermidis (31.3%), group A beta-hemolytic streptococcus (12.5%), Streptococcus pneumoniae (6.3%) and Escherichia coli (6.3%). One of the specimens yielded mixed organisms (Staphylococcus epidermidis and Streptococcus pneumoniae). Penicillin resistance was documented in six (37.5%) of the 16 gram-positive bacteria isolated from the pus culture. Both throat and blood cultures were available in all 132 patients. Seven throa...
Research Interests: Adolescent, Medicine, Humans, Child, Escherichia coli, and 15 moreFemale, Male, Staphylococcus aureus, Infant, Staphylococcus epidermidis, Gram Positive Bacteria, Retrospective Studies, Bacterial growth, Bacterial infections, Neck, Lymphadenitis, Acute Disease, Child preschool, Streptococci, and Paediatrics and reproductive medicine
We report the case of a five-year-old healthy boy who was admitted with abscess and soft tissue infection between the left wrist and the distal end of the forearm. Postero-anterior X-ray examination of the forearm showed a transverse line... more
We report the case of a five-year-old healthy boy who was admitted with abscess and soft tissue infection between the left wrist and the distal end of the forearm. Postero-anterior X-ray examination of the forearm showed a transverse line on the radius; however, further comparative radiographic examinations of the forearm were not compatible with fracture. Enterobacter cloacae was identified in the pus culture and initial intravenous empiric treatment with sulbactam-ampicillin was continued. Although the microorganism was susceptible to the empiric antimicrobial agent, at the eighth day of the treatment, inflammatory drainage was still present so further evaluations were performed. Ultrasonography of the forearm and wrist revealed only collection; magnetic resonance imaging showed a foreign body on the anterior distal section of the left forearm. The patient underwent operation and a 22 mm wooden foreign body was removed. Detailed history after removing a tree branch particle reveal...
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A Substantial ratio of bacterial meningitis survivors suffers mild or serious intellectual and neuropsychological handicaps. We organized eighty subjects into three groups: 1) Pneumococcal meningitis (PM) who did not receive... more
A Substantial ratio of bacterial meningitis survivors suffers mild or serious intellectual and neuropsychological handicaps. We organized eighty subjects into three groups: 1) Pneumococcal meningitis (PM) who did not receive dexamethasone, 2) PM who received dexamethasone, 3) Other bacterial meningitis with different etiology. All subjects underwent Bender Visual Motor Gestalt test and age-appropriate Intelligence quotient (IQ) tests. The mean full-scale IQ scoring fell within normal range (90+/-17) in the post-meningitic cohort. There was no statistical difference between two pneumococcal groups regarding full scale IQ testing (88+/-16 and 91+/-18) and Bender-Gestalt scoring (4.0+/-3.3 and 3.8+/-2.6), respectively. However, the subjects with full scale IQ score &lt;85 (below the average) were statistically less in the group with steroid therapy. PM patients who received dexamethasone therapy had statistically better academic performance. As a result, adjuvant steroid therapy has no significant impact on overall intellectual tests in PM subjects. However, dexamethasone seems to diminish development of below the average IQ scoring in PM cases. In addition, PM subjects who received steroids showed better academic achievement. These findings may support the idea of dexamethasone administration prior to first antibiotic dose in PM subjects.