Objective: The aim of present study was (a) to evaluate the relationship between the neutrophil/lymphocyte (N/L) ratio and mutation types of familial Mediterranean fever (FMF) in children and (b) to evaluate the relationship between the N/L ratio and age.Material and Methods: Three hundred forty-three children with familial Mediterranean fever in the attack-free period and 283 healthy control children were included in the study. Patients were divided into subgroups according to mutation types. Neutrophil and lymphocyte counts were retrieved from medical records of patients and the N/L ratio was calculated from these parameters. Results:The N/L ratio of patients was found to be significantly higher than that of controls (p<0.001). Among 343 patients, homozygous, heterozygous, and compound mutations were observed in 39, 253, and 51 patients, respectively. The differences in the N/L ratio among patients with homozygous, heterozygous, and compound mutations were not statistically significant. The most common mutations were M694V (n=126), E148Q (n=70), M680I, (n=33), and V726A (n=28). Significant differences were not observed among these mutations in terms of the N/L ratio (p>0.05). In all subjects, there was a weak but significant relationship between age and the N/L ratio (r: 0.215, p<0.001). Conclusion:The N/L ratio, which can be determined by simple methods in routine blood tests, may be used for the follow-up monitoring of chronic inflammation in patients. In addition, the N/L ratio may give an idea to clinicians regarding the early initiation of treatment in patients with typical clinical findings of FMF.

HD is a significant condition that should be treated appropriately to avoid serious complications.

ÖZET: Valproik asit (VPA) epilepsi tedavisinde yaygın olarak kullanılan bir kimyasal ajandır. Son zamanlarda yapılan çalışmalar VPA'in nöronlar üzerine bazı olumsuz etkilerinin olabileceğini göstermiştir fakat bu konu henüz netlik kazanmamıştır. Bu çalışmanın amacı VPA'in sıçanlarda pentilentetrazol (PTZ) ile oluşturulan epileptik nöbet sonrası hipokampüs ve kortekste meydana gelen DNA hasarı ve apoptozis üzerine etkisini ortaya koymaktır. Çalışmada 18 adet 230-250 gram ağırlığında erkek sıçan kullanılmıştır. Sıçanlar kontrol (serum fizyolojik 1 ml kg -1 + serum fizyolojik 1 ml kg -1 ; n=6), PTZ (serum fizyolojik 1 ml kg -1 + PTZ; n=6) ve VPA (150 mg kg -1 VPA + PTZ; n=6) olmak üzere üç gruba ayrılmıştır. PTZ grubu ve VPA grubuna belirtilen dozlarda uygulanmasından yarım saat sonra 45 mg kg -1 pentilentetrazol intraperitoneal olarak uygulanarak nöbet oluşumu sağlanmıştır. Nöbet oluşumundan 24 saat sonra tüm sıçanların beyin dokuları çıkarılmış, korteks ve hipokampüs bölgeleri alınmıştır. Korteks ve hipokampüs dokularında enzim bağlı immüno sorbent (ELISA) yöntemi ile DNA hasar belirteci olan 8-hidroksi-2'-deoksiguanozin (8-OhDG) ve apoptozis belirteci olan caspase-3 ölçülmüştür. One way ANOVA varyans analizi ile istatistiksel değerlendirme yapılmıştır. PTZ grubunda 8-OhDG seviyesi hem korteks hem de hipokampüste kontrol grubuna göre artmıştır (p<0.05). Bununla birlikte, VPA nöbet sonrası 8-OhDG seviyesini korteks ve hipokampüste PTZ grubuna kıyasla yükseltmiştir (p<0.05). Ayrıca, kortekste caspase-3 seviyesi PTZ grubunda kontrole göre anlamlı olarak artmıştır (p<0.05). Bunun yanı sıra, VPA kortekste PTZ grubuna kıyasla caspase-3 seviyesini anlamlı olarak yükseltmiştir (p<0.05). Sonuç olarak, VPA sıçanlarda nöbet sonrası meydana gelen DNA hasarı ve apoptozisi arttırmıştır.

BACKGROUND: Hypoxic ischemic encephalopathy (HIE) is one of the most important causes of mortality and morbidity in newborns. Few studies with conflicting results have been conducted on the effect of perinatal asphyxia and thyroid hormones METHODS: A total of 96 newborns (46 patients with HIE and 50 controls) were included in the study. Electroencephalography (EEG) results, cranial magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), Sarnat Stages, and the presence of seizures of the HIE group were recorded. Thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels of all cases were also measured between 5-10 days. Patients with HIE were separated into 3 groups according to the fT4 (≤1.52 ng / dL, 1.52-1.84 ng / dL, and ≥1.84 ng / dL), and TSH (≤2.56 IU / mL. 2.56-5.3 1IU / Ml, and ≥5.31 IU / mL) levels. RESULTS: All the newborns with seizures were in the 1st or 2nd tertiles of fT4, none of those with high fT4 (>1.84 ng/dL), and the difference was statistically significant (x2=6.61; p=0.036). A negative correlation was determined between fT4 level and duration of hospitalization (=-0.43; p=0.03), duration of respiratory support (r=-0.32; p=0.029), duration of intubation (r=-0.40; p=0.006), and time to full oral feeding (r=-0.40; p=0.006). The TSH level was only correlated with the duration of hospitalization (r=-0.34, p=0.02). CONCLUSIONS: Free T4 level may be used as a prognostic marker in newborns with HIE. Further multicenter, larger, and prospective studies are needed to support and confirm these findings.

Necrobiosis lipoidica diabeticorum (NLD) is an idiopathic cutaneous granulomatous dermatitis. The disease is usually seen in people with diabetes mellitus. The treatment of NLD is quite difficult and takes a long time, particularly in ulcerated forms. In this case, a girl with 10 years of age is presented with a persistent plaque which had been present for 2.5 years on her left shin. Local treatment with pimecrolimus (Elidel 1.0% cream) twice daily for one month, in addition to glucose control provided a progressive improvement of the lesion. So, pimecrolimus may be used safely and effectively in the treatment of NLD. Key words: child; diabetes mellitus; necrobiosis lipoidica; pimecrolimus Özet:Nekrobiyozis lipoidika diyabetikorum (NLD), idiyopatik kutanöz granulamatöz bir dermatittir. Hastalık genellikle diyabetik popülasyonda görülür. NLD'nin tedavisi, özellikle ülsere formlarda, oldukça zordur ve uzun zaman alır. On yaşında kız çocuk, 2,5 yıldır sol bacağında olan inatçı bir plak ile başvurdu. Glikoz kontrolüne ek olarak bir ay boyunca günde iki kez lokal pimekrolimus (Elidel %1 krem) tedavisi ile lezyonda belirgin düzelme sağlandı. Sonuçta, pimekrolimus NLD tedavisinde güvenli ve etkili bir şekilde kullanılabilir.