Loss of peritoneal function due to peritoneal fibrosing syndrome (PFS) is a major factor leading to treatment failure in chronic peritoneal dialysis (PD) patients. Although the precise biologic mechanisms responsible for these changes have not been defined, the general assumption is that alterations in peritoneal function are related to structural changes in the peritoneal membrane. Studies of the peritoneal membrane by non-invasive ultrasonography (US) in chronic PD patients are limited. The aim of the present study is to assess the relationship between functional parameters of peritoneum and peritoneal thickness measured by US in children treated by chronic PD. We recruited two groups of patients: 23 subjects (13 females, 10 males) on chronic PD (patient group) and 26 (7 females, 19 males) on predialysis out-patient follow-up (creatinine clearance: 20-60 mL/min/1.73 m 2 ) (control group). Age, sex, weight, height, body mass index (BMI), chronic PD duration, episodes of peritonitis and the results of peritoneal equilibration test (PET) were recorded. Hemoglobin (Hb), blood pressure (BP), left ventricular mass index (LVMI) and renal osteodystrophy (ROD) parameters were also obtained. The thickness of the parietal peritoneum was measured by trans-abdominal US in all children. Statistical analyses were performed by using Student's t and Pearson's correlation tests. Mean peritoneal thickness in chronic PD patients (1028.26 ± 157.26 mm) was significantly higher than control patients (786.52 ± 132.33 (R 2 ¼ 0.81, p50.05). No correlation was found between peritoneal thickness and Hb, BP, LVMI and ROD parameters. In conclusion, ultrasonographic measurement of peritoneal membrane thickness is a simple and non-invasive method in chronic PD children. This diagnostic tool likely enables to assess peritoneal structure and function in these patients.

Objective: This study describes a single-center experience on percutaneously performed partial omentectomy procedure in pediatric peritoneal dialysis (PD) patients who showed early catheter dysfunction and required catheter replacement due to catheter flow obstruction. Materials and methods: We performed a retrospective review of clinical outcomes from pediatric PD patients who underwent percutaneous catheter replacement by pediatric nephrologists between November 1995 and December 2012. Partial omentectomy was performed in those patients in whom omental or adhesion trapping to the catheter tip was seen. Results: During the study period, catheter dysfunction that eventually required percutaneous catheter replacement occurred in 32 (23.7%) children. Of these, 9 patients were performed partial omentectomy. Mean age at initiation of PD and time of omentectomy was 97.48 ± 46.06 and 98.53 ± 45.55 months, respectively. Catheter dysfunction appeared after a mean 1.20 ± 1.0 months. The causes of catheter dysfunction were omental wrapping and malposition. No peritonitis occurred before omentectomy. Mean total operation time was 60 ± 8.83 min. No complications were encountered during the procedure. After omentectomy, mean catheter survival period was 5.92 ± 6.88 months. A total of five peritonitis episodes occurred. Three patients were transferred to hemodialysis. Six patients were on PD treatment without any problem at the end of the first year of their follow-up. Two patients underwent kidney transplantation. Four patients were still on chronic PD treatment at the end of the study period. Conclusion: When performed by an experienced nephrologist, the performance of partial omentectomy by percutaneous route, when required, is an easy, safe and efficient therapeutic procedure in children on chronic PD treatment.

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Ramsay Hunt Syndrome (RHS) was first described by J.Ramsay Hunt in 1907. Ramsay Hunt Syndrome also known as Herpes Zoster Oticus consists of facial paralysis accompained by the presence of erythematous vesicles on ear and/or oral mucosa and otalgia. This syndrome is most common in adults and older children and very rare in young children. Affected children display mild symptoms than adults. Following the primary infection, Varicella Zoster Virus (VZV) becomes latent in the cells of the sensory ganglia and a reactivation associated with supressed cell-mediated immunity may occur after a period of time, resulting in RHS. Although subfebrile fever and chickenpox-like rash can happen from Varicella vaccine, the risk of RHS is extremely rare after immunization. It has been reported that the microorganism introduced into the body by means of live attenuated varicella vaccine becomes activated and causes varicella especially in immunocompromised patients. Following receipt of varicella vaccine, RHS has also been reported to occur rarely. We, herein, report the case of 13-month-old female patient with infantile nephrotic syndrome that who developed RHS after her immunization with vaccine in combination with varicella other live vaccines.

Haemophilus influenzae, particularly in children, causes local and systemic infections such as meningitis, pneumonia, epiglottitis, otitis media, sinusitis and bacteremia. This bacterium has rarely been implicated as the causative agent of urinary tract infections (UTIs) in children. Most of the reported cases on UTIs due to H. influenzae were associated with urinary tract abnormalities and/or recurrent UTIs. Because of the inability of H. influenzae to grow in standard media commonly used for urine cultures, the true incidence of UTIs due to this potential pathogen is unknown. In this report, we present a case of UTI caused by H. influenzae in a 17-year-old boy with bilateral nephrolithiasis and hydronephrosis. To our knowledge, this is the first reported case of UTI caused by H. influenzae in Turkey. KEY wORdS: Haemophilus influenzae, Urinary tract infections, Urine ÖzHaemophilus influenzae, özellikle çocuklarda, menenjit, pnömoni, epiglottit, otitis media, sinüzit ve bakteriyemi gibi lokal ve sistemik enfeksiyonlara yol açmaktadır. Bu bakteri, çocuklarda üriner sistem enfeksiyonlarının (ÜSİ) etkeni olarak nadiren izole edilmiştir. H. influenzae'ye bağlı olarak gelişen ÜSİ ile ilgili bildirilen olguların çoğu, üriner sistem anormallikleri ve/veya tekrarlayan ÜSİ ile ilişkilendirilmiştir. H. influenzae'nın idrar kültürleri için yaygın olarak kullanılan standart besiyerlerinde ürememesi nedeniyle, bu potansiyel patojene bağlı olarak gelişen ÜSİ'nın gerçek insidansı bilinmemektedir. Bu raporda, bilateral nefrolitiyazisi ve hidronefrozu olan 17 yaşındaki bir erkek çocukta H. influenzae'ya bağlı olarak gelişen ÜSİ olgusunu sunuyoruz. Bildiğimiz kadarıyla, Türkiye'de bildirilen H. influenzae'nın etkeni olduğu ilk ÜSİ olgusudur. AnAhtAr sözcükler:Haemophilus influenzae, Üriner sistem infeksiyonları, İdrar