Turkish J Pediatr
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Syncope is defined as a sudden transient loss of consciousness. Vasovagally mediated hypotension and bradycardia are believed common, yet difficult to diagnose, causes of syncope in healthy children and adolescents. These episodes are often both sudden and sporadic in nature and, if recurrent and severe (malignant vasovagal syncope), can be a source of morbidity and possibly mortality. ⋯ Sertraline hydrochloride, a serotonin reuptake inhibitor, has been reported to be effective in preventing the vasovagal syncopal episodes in children and adults. Here, two cases of recurrent, unexplained syncope are presented. Both were under sertraline therapy and underwent provocative head-up tilt testing that resulted in asystole.
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It is well known that young children have tendency to place objects in their mouths, frequently leading to aspiration of foreign bodies (FBs) into the tracheobronchial tree (TBT). The patient group comprised 596 patients with a history of suspected aspiration of FBs into the TBT who were bronchoscoped for diagnosis and treatment. There were 306 male (51.3%) and 290 female (48.7%) patients, with a mean age of 2.4 years (range 3 months-13 years). ⋯ In conclusion, patients with FB aspiration are rapidly recognized from their histories and easily treated by bronchoscopy and extraction of the aspirated foreign body. A high index of suspicion is crucial for early diagnosis. However, education is the best preventive measure for decreasing the incidence of this problem.
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Turkey has a young population as a result of high fertility and growth rates in the recent past. Thirty-five percent of the population is less than 15 years of age, and 25 percent of the population comprises reproductive-age woman. The latest estimate of the population growth rate was 19 per thousand for the 1990-1995 period. ⋯ The government also pays special attention to the socio-economic priority areas of the country and initiates special health programs in these areas first, in order to reduce high regional differences in MCH indices. Despite these dramatic improvements, one great obstacle is the high maternal and infant mortality and morbidity rates in the country at the time of ratification of the European Social Charter. The success made so for in maternal and child health should not be ignored, but it must be realized that much still remains to be done to improve the MCH level further.
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Case Reports
Intracerebral hemorrhage: a rare late manifestation of vitamin-K deficiency in a breastfed infant. A case report.
Late hemorrhagic disease of the newborn (HDN) is a rare complication of vitamin-K deficiency and is especially associated with intracranial hemorrhage. It may also occur in infants who received vitamin-K prophylaxis at birth. ⋯ This form of intracranial hemorrhage of late HDN has been reported in the literature very rarely. We conclude that the efficiency of single-dose vitamin-K prophylaxis should be revaluated.
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The polymerase chain reaction (PCR) using oligonucleotides based on the repetitive sequence (IS6110) of Mycobacterium tuberculosis as a primer was evaluated for detection of M.tuberculosis in clinical samples. We tested 55 clinical specimens from patients suspected of having tuberculosis and 71 specimens from control subjects. PCR was more sensitive than culture (positivity rate was 14.5% and 36.3%, respectively, in suspected patients). This approach to the diagnosis of tuberculosis is a valid diagnostic alternative to classical procedures.