ObjectivesTo investigate the optical coherence tomography angiography (OCTA) and specular microscopy (SM) findings in obese children and compare them with healthy ones.MethodsIn this prospective study, 50 eyes of 25 obese children [body mass index (BMI) ≥95th percentile], 36 eyes of 18 control age- and sex- matched healthy subjects (BMI <85th percentile) were included. Demographic features and ophthalmological examination including OCTA measurements as well as SM findings were assessed. Cellular morphology was observed by noncontact SM and results for corneal endothelial cell density (cells/mm2), coefficient of variation of cell size and percentage of hexagonal cells were obtained. The OCTA was performed with 6 × 6 mm sections for macula and 4.5 × 4.5 mm sections for optic disc in all eyes. Foveal retinal thickness (FRT), retinal nerve fiber layer (RNFL) thickness, vessel density in different sections of retina and optic nerve head were analyzed.ResultsAll SM parameters, RNFL thickness for average, and all quadrants and optic disc radial peripapillary capillary densities were similar between groups. However, FRT, flow area for choriocapillaris, superficial and deep foveal capillary densities were significantly higher in obese group when compared to controls (242.4 ± 18.2 µm vs. 232.1 ± 16.5 µm, p=0.024, 2.2 ± 0.1 mm2 vs, 2.2 ± 0.0 mm2, p=0.042, 22.4 ± 6.9% vs. 15.6 ± 5.5%, p=0.001, and 38.9 ± 7.5% vs. 31.1 ± 8.6 %, p=0.001, respectively).ConclusionsObese children seem to have higher values of FRT, flow area for choriocapillaris, superficial and deep foveal capillary densities. These results may have significant implications for understanding of how childhood obesity could affect retinal microvasculature.
Objectives
In this article, in light of the literature, we aimed at discussing data obtained from patients in which extrapyramidal adverse effects that are misdiagnosed as varied clinical presentations developed due to metoclopramide, which is frequently prescribed in pediatric emergency services and in family practice centers for its powerful and rapid antiemetic action.
Methods
The files of patients who presented to a pediatric clinic at the research hospital of Mustafa Kemal University between January 2017 and January 2018 and who were diagnosed as having acute dystonic reaction were reviewed retrospectively.
Results
Generalized hypertonicity in 4 patients, abnormal involuntary movements in 2 patients, oculogyric crisis in 2 patients, local hypertonia in the wrist and fingers in 2 patients, spasmodic cervical hypertonicity in 2 patients, and trismus in 1 patient were found. Of the patients, 2 were directed to our clinic with early diagnosis of hypocalcemia, 2 with conversion, 3 with meningitis, 1 with epileptic seizure, 1 with status, 1 with mandibular luxation, 1 with tetanus, and 2 with intracranial pathology.
Conclusions
The extrapyramidal adverse effects of metoclopramide, which is frequently prescribed in pediatric emergency services and in family practice centers, are highly terrifying for children and parents. Furthermore, it may cause severe anxiety especially in pediatric emergency services because it may mimic many serious diseases.
Familial Mediterranean Fever (FMF), which is an autosomal recessive disease characterized by recurrent self-limiting fever, peritonitis, pleuritis, arthritis and erysipelas-like erythemas, has been common among ethnic groups such as Turkish, Armenian, Arabic and Jewish. The clinical presentation is caused by mutations in the MEFV gene encoding the Pyrin protein. In this study, we aimed to present a new mutation that has not been previously defined from the mutations in the MEFV gene which is responsible for the genetic pathology of familial Mediterranean fever and to evaluate the frequency of distribution of the MEFV gene mutation among different ethnic groups living in our region. In present retrospective study, a total of 2639 clinically suspected FMF patients who were referred to Hatay Mustafa Kemal University Hospital between 2010 and 2017 were recorded. MEFV gene mutations were observed using DNA sequence analysis. MEFV mutations were found in 2079 of the 2639 patients (78.7%) Among these patients 184 (6.97%) were homozygous, while 1365 (51.72%) were heterozygous. The most frequently observed mutation was R202Q (1319, 19.55%) followed by E148Q (n = 476, 7.05%), M694V (n = 439, 6.51%), V726A (n = 146, 2.16%) and M680I (n = 135, 2%). In a case clinically diagnosed as FMF, a new mutation called S145G (p. Ser145Gly, c.433A > G) was identified in exon 2 of the MEFV gene. Besides, addition of a new pathogenic MEFV variant to the literature, the relationship between the FMF clinic and homozygous form of R202Q, which was previously considered as a polymorphism, was highlighted.
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