Background/AimsBrucellosis patients present various non-specific clinical symptoms, such as fever, fatigue, sweating, joint pain, arthritis, myalgia, and headache. Based on the nonspecifity of its clinical signs and symtoms, we decided to evaluate whether mean platelet volume (MPV) , neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) will contribute to the diagnosis.MethodsIn this retrospective study, we reviewed hospital-records of 60 children with a confirmed diagnosis of brucellosis in Kayseri between January 2013 and January 2016, and compared the hematological parameters; white blood cell (WBC) count, hemoglobin (Hb), neutrophil count, lymphocyte count, platelet count, MPV, NLR, and PLR with 55 healthy age and gender matched children. Also, the well known inf lammation markers; erytrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were compared between the patient and control group.ResultsWe found significant difference among the Hb, platelet count, MPV and NLR values between the patient and control group (p < 0.05). There was no difference between WBC, neutrophil count, lymphocyte count and PLR between the patient and control group (p > 0.05). When the patients were divided into groups as arthritis positive and arthritis negative and compared to the control group; we found that the NLR is more significant in between the arthritis positive and control group (p = 0.013). Also, we found significant difference among the ESR and CRP values between the patient and control group (p < 0.001).ConclusionsThe results of this study indicates that MPV and NLR values can be used as markers of inflammation in childhood brucellosis. Also, NLR is more valuable in children with brucella arthritis.

Migraine is a commonly seen neurovascular disorder during childhood. Inflammation induced by the activation of cytokines and neuropeptides is implied in its pathophysiology. There is an association between inflammation and atherosclerosis in patients with migraine. In addition, there is a strong correlation between early atherosclerotic wall lesions and carotid intima-media thickness (CIMT). The study population consisted of 57 migraine patients aged 5-17 years, as well as 47 healthy children who served as the control group. Those migraine patients who were not receiving any medications at the interictal period were compared to healthy controls in terms of their measured lipid levels, thyroid function, vitamin B12 levels, serum iron levels, iron binding capacity, complete blood count, C-reactive protein (CRP) levels, and carotid intima-media thickness (CIMT) scores, which may comprise risk factors for atherosclerosis. When children in the migraine and control groups were compared in terms of those risk factors that are known to be related to vascular changes, no significant differences were found. However, a significant difference was detected in CIMT values (P < 0.05). Atherosclerosis commences in childhood, and there is a long period of time before the onset of ischemic symptoms occurs. In children with migraine, an evaluation of CIMT can be used as a non-invasive imaging modality to detect atherosclerosis, which develops in the context of chronic inflammation. In this way, measures to reduce morbidity and mortality, which may result from cardiovascular diseases, can be implemented.

Aim: Platelets which are known to play a role in inflamation change their shapes when they are activated and this change is reflected in mean platelet volume and platelet distribution width values. Therefore, the mean platelet volume and platelet distribution width values are considered to be beneficial parameters for the diagnosis and treatment of many inflammatory diseases. The aim of the study was to evaluate platelet volume indices in children with acute bronchiolitis. Material and Methods:A total of 514 infants who were below the age of 2 years old were evaluated in this study. Three hundred thirteen of these infants were diagnosed with acute bronchiolitis patients and 201 were healthy children. The patients were separated into four groups as mild, moderate, severe bronchiolitis and the control patient group. The groups were evaluated in terms of significant differences in the values of mean platelet volume and platelet distribution width. A p value of <0.05 was considered statistically significant for all results. Results:The mean platelet volume was found to be 6.8±0.6 fL in the patients with mild bronchiolitis attack, 6.7±0.6 fL in the patients with moderate bronchiolitis attack, 6.5±0.5 fL in the patients with severe bronchiolitis attack and 7.3±1.1 fL in the control group. The mean platalet volume was statistically significantly lower in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). The platelet distribution width was found to be 17.2%±0.83 in the mild bronchiolitis attack group, 17.1%±0.96 in the moderate bronchiolitis attack group, 17.3%±0.87 in the severe bronchiolitis attack group and 16.9±1.6% in the control patient group. This difference was not statistically significant (p=0.159). The platelet count was statistically significantly higher in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000).

Real euglycemic diabetic ketoacidosis [DKA; blood glucose <200 mg/dL (11.1 mmol/L)] is rare, and long-lasting starvation conditions due to intervening diseases in type 1 diabetes mellitus patients may also cause it. Euglycemic DKA is also reported in insulin-dependent diabetics with depression, alcoholics, glycogen storage diseases, and chronic liver disease apart from pregnant cases. This case report is presented to emphasize the importance of evaluation of acid-base state, urine glucose, and ketone values at the application in all newly diagnosed type 1 diabetic patients with normal glucose levels by defining euglycemic DKA that resulted from long-lasting starvation during Ramadan fasting in a newly diagnosed 14-year-old male patient.

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