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Purpose: To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers. Materials and methods: A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived nutritional status) was developed and tested for the study. Correlation between nutritional status and Gross Motor Function Classification System (GMFCS) levels was assessed using continuous variables (Z-scores for weight-for-age, height-for-age, weight-for-height, and body mass index-for-age), and categorical variables (being malnourished, stunted, or wasted). HCP and caregiver perceptions of the child's nutritional status as well as agreement between perceived and objective nutritional status and agreement between perceived nutritional status and concerns about the nutritional status were analyzed. Results: Data were available for 497 participants from eight European countries. Poorer nutritional status was associated with higher (more severe) GMFCS levels. There was minimal agreement between perceived and objective nutritional status, both for HCPs and caregivers. Agreement between HCP and caregiver perceptions of the child's nutritional status was weak (weighted kappa 0.56). However, the concerns about the nutritional status of the child were in line with the perceived nutritional status. Conclusions: The risk of poor nutritional status is associated with more severe disability in children and adolescents with CP. There is a mismatch between HCP and caregiver perceptions of participants' nutritional status as well as between subjective and objective nutritional status. Our data warrant the use of a simple and objective screening tool in daily practice to determine nutritional status in children and adolescents with CP., Danone Nutricia Research, Utrecht, the Netherlands; Nutricia Advanced Medical Nutrition in Czech Republic; Nutricia Advanced Medical Nutrition in Greece; Nutricia Advanced Medical Nutrition in Hungary; Nutricia Advanced Medical Nutrition in Italy; Nutricia Advanced Medical Nutrition in Poland; Nutricia Advanced Medical Nutrition in Slovakia; Nutricia Advanced Medical Nutrition in The Netherlands; Nutricia Advanced Medical Nutrition in Turkey; Danone Nutricia Research, This study was sponsored by Danone Nutricia Research, Utrecht, the Netherlands. Local financial support was provided by the local business units of Nutricia Advanced Medical Nutrition in Czech Republic, Greece, Hungary, Italy, Poland, Slovakia, The Netherlands, and Turkey. Medical writing support was provided by Tim Kelly, Medi-Kelsey Limited, funded by Danone Nutricia Research.

Chronic cough is the most common complaint during childhood. Various pathophysiologic mechanisms may cause cough. Knowledge of the mechanisms underlying chronic cough plays an important role in the choice of treatment to evaluate the role of leukotrienes in children with nonspecific isolated chronic dry cough. The patient group consisted of children with isolated chronic dry cough persisting for > 4 weeks and the control group included healthy children. Medical histories were elicited and physical examinations were performed, then respiratory function testing was done and chest X-rays were obtained. Patients were given inhaled corticosteroid. The urine leukotriene E4 (uLTE4) levels in the patient and control groups was measured by enzyme immunoassay. The patient group included 55 patients, 25 of them were males between 6 and 12 years old. The control group included 25 healthy children between 6 and 12 years old, 12 of them were males. There were no pathologic findings on physical examinations, pulmonary function testing, and chest X-rays. The complaints of cough in 50 patients were resolved after treatment. The median level of uLTE4 was 73.1 ng/mmol creatinine (range, 15.59-787.55 ng/mmol creatinine) in the patient group, and 64.2 ng/mmol creatinine (range, 12-282 ng/mmol creatinine) in the control group. No significant difference was detected between the 2 groups with respect to age, gender, and uLTE4 levels. Different pathophysiologic mechanisms are known to influence nonspecific isolated chronic dry cough. Various mechanisms, other than leukotrienes, may also give rise to dry cough.

Aim:Most of the childhood elbow area fractures constitute supracondylar humerus fractures. The treatment approach in Gartland type II fractures is controversial. The purpose of our study was to compare the effectiveness of cast and splint in conservative treatment of type II supracondylar humerus fractures.Methods:Sixty-nine pediatric patients admitted to our clinic due to gartland type II supracondylar humerus fractures between 2015 and 2020 were retrospectively evaluated. Closed reduction upper-elbow cast was applied to 26 patients, and closed reduction upperelbow splint treatment was applied to 43 patients. Radiological results of the patients were compared.Results:The mean age of the patients participating in the study was 4.86±2.61. Forty-two of 69 patients were male and 27 were female. Neurovascular deficit and compartment syndrome were not observed in any of the patients. When compared radiologically, no significant difference was found between the two groups.Conclusion:Type II supracondylar humerus fractures, where conservative treatment is planned, the upper elbow casting or splint selected for immobilization shows similar effectiveness in protecting reduction.

Aim We aim to describe the demographic characteristics, etiology, neurophysiology, imaging findings, treatment, prognosis, and prognostic factors of acute flaccid myelitis. Methods The clinical data, laboratory test and, magnetic resonance imaging (MRI) results of pediatric patients diagnosed with acute flaccid myelitis according to the Centers for Disease Control criteria between August 1, 2016, and December 31, 2018, from 13 centers in Turkey were reviewed. Results Of the 34 cases identified, 31 were confirmed (91.2%). Eighteen patients (55.9%) were boys. The median patient age was 4 years (interquartile range 2.5–6.9 years). Most of the patients were admitted in 2018 (n = 27). A preceding history of a febrile illness was reported in all patients, with a median of 4 days (interquartile range 3–7 days) before symptom onset. Thirty-one patients had T2 hyperintensity on spinal MRI, and 18 patients had cerebrospinal fluid pleocytosis. The most common infectious agents were entero/rhinoviruses (n = 5) in respiratory specimens. All patients except one received immunotherapy either alone or in combination. Among 27 patients with follow-up data 24 had persistent weakness. Involvement of four limbs together with an abnormal brain MRI at onset were associated with a poor prognosis. Conclusion The number of patients with acute flaccid myelitis increased since 2012, spiking with every 2-year interval, largely in the pediatric population. The median age decreases with every outbreak. Clinicians should be aware of the clinical picture for early collection of specimens and early start of rehabilitation programs. Further studies are needed to better characterize the etiology, pathogenesis, risk factors, and treatment of this rare condition.

Aim:Septic arthritis may represent a direct invasion of joint space by various microorganisms. The aim of this study was to determine the epidemiological characteristics of patients with septic arthritis in our clinic and to discuss the diagnosis, treatment and management.Methods:Thirty-four patients diagnosed with septic arthritis between June 2008 and December 2014 were retrospectively evaluated. Clinical and epidemiological characteristics of the patients, microorganisms causing infection and treatment choice were analyzed.Results:Most patients were male (55.9%) and the mean age of the patients was 42.8 (1-87) years. The knee was the most often affected joint (91.6%). Fever was present in only 17.6% of the cases. Gram staining was positive in only 17.6% of the synovial fluid samples analyzed. Among the 34 patients studied, 10 had positive synovial fluid culture (29.4%). Staphylococcus aureus was the most common pathogen.Conclusion:Gram negative staining, absence of fever and normal leukocyte count do not rule out septic arthritis but only reduce the possibility. Samples should be taken prior to antibiotic treatment to avoid false negative detection of positive samples. Serial needle aspiration, drainage and empirical antibiotherapy should be kept in mind in the treatment of septic arthritis.

Objectives Acute seizures and post-stroke epilepsy have been reported more frequently in patients with pediatric stroke than adults. Acute seizures in the first days of a stroke may deteriorate stroke and ischemia-related neurodegeneration and contribute to the development of post-stroke epilepsy. In this study, we aimed to investigate risk factors for the development of post-stroke epilepsy in children with arterial ischemic stroke. Materials and Methods We recruited 86 children with arterial ischemic stroke. We analyzed variables, including age at admission, gender, complaints at presentation, focal or diffuse neurologic signs, neurologic examination findings, laboratory investigations that were conducted at admission with stroke (complete blood cell count, biochemical-infectious-metabolic-immunological investigations, vitamin B12 levels, vitamin D levels), neuroimaging results, etiologies, time of the first seizure, time of remote seizures, and development of neurologic deficit retrospectively. Seizures during the first six hours after stroke onset were defined as ‘very early seizures’. ‘Early seizures’ were referred to seizures during the first 48 h. Patients who experienced two or more seizures that occurred after the acute phase of seizures were classified as ‘epileptic.’ A binary logistic regression analysis was used to estimate risk factors. Results An acute seizure was detected in 59% and post-stroke epilepsy developed in 41% of our cohort. Binary logistic regression analysis demonstrated that ‘very early seizures’ increased epilepsy risk six-fold. Epilepsy was 16 times higher in patients with ‘early seizures’. Low vitamin D levels were defined as a risk factor for post-stroke epilepsy. Conclusion Seizures in the very early period (within the first six hours) are the most significant risk factors for the development of post-stroke epilepsy Further studies regarding seizure prevention and neuroprotective therapies are needed because post-stroke epilepsy will affect long term prognosis in patients with pediatric stroke.

Background. - Hereditary polyneuropathies are heterogeneous group of diseases of the peripheral nervous system. In this study, we investigated the demographic, clinical, electrophysiological, and genetic characteristics of hereditary polyneuropathy patients diagnosed and followed up in our tertiary center clinic in Izmir, Turkey. Methods. - Patients who were diagnosed with hereditary polyneuropathies during nerve conduction studies in our center were evaluated retrospectively. Results. - In a total of 1484 nerve conduction studies, 207 patients were diagnosed with polyneuropathy. Ninety-nine of those patients were determined to have hereditary polyneuropathy, 52 of which were male and 47 were female. Sixty-nine patients with hereditary polyneuropathy were compatible with axonal and 30 were compatible with demyelinating polyneuropathy. Genetic analysis was performed in 69 patients, and 49 of those patients were genetically diagnosed, leading to a diagnosis rate of 71%. Conclusions. - Advances in genetics have led to an increase in the heterogeneity of hereditary polyneuropathies, causing difficulties in the use of existing classifications. Although typical mutations expected in childhood-onset polyneuropathies are seen less frequently, polyneuropathies are frequently encountered as findings of complex, multisystemic diseases. (C) 2020 Elsevier Masson SAS. All rights reserved.

Aim: In this study, we aimed to discuss the result of arthroscopic surgery for shoulder instability and we planned to show the value of instability tests for determining success of surgery. Methods: Patients, who were operated for shoulder instability between 2008 and 2013, were included in this study. Visual analogue scale, Rowe and Oxford shoulder scores of the patients were recorded preoperatively and at the final follow-up visit. Physical examination finding were noted at the final follow-up visit. Results were analyzed using SPSS. Results: Twenty one patients were included in this study. Re-dislocation was detected in two patients. There was no re-dislocation in patients with an osseous Bankart lesion. All clinical scores improved in all patients, however those with a negative apprehension test had better clinical scores. Conclusion: Arthroscopic Bankart repair is an effective procedure for the treatment of shoulder instability. Presence of osseous Bankart lesion plays an important role in the prognosis. Apprehension test is useful for assessing shoulder stability in the postoperative follow-up.

WOS: 000404044200010, PubMed ID: 28464723, Congenital myasthenic syndromes are clinically and genetically heterogeneous disorders of neuromuscular transmission. Most are treatable, but certain subtypes worsen with cholinesterase inhibitors. This underlines the importance of genetic diagnosis. Here, the authors report on cases with genetically proven congenital myasthenic syndromes from Turkey. The authors retrospectively reviewed their experience of all patients with congenital myasthenic syndromes, referred over a 5-year period (2011-2016) to the Child Neurology Department of Dokuz Eylul University, Izmir, Turkey. In addition, PubMed was searched for published cases of genetically proven congenital myasthenic syndromes originating from Turkey. In total, the authors identified 43 (8 new patients, 35 recently published patients) cases. Defects in the acetylcholine receptor (n = 15; 35%) were the most common type, followed by synaptic basal-lamina associated (n = 14; 33%) and presynaptic syndromes (n = 10; 23%). The authors had only 3 cases (7%) who had defects in endplate development. One patient had mutation GFPT1 gene (n = 1; 2%). Knowledge on congenital myasthenic syndromes and related genes in Turkey will lead to prompt diagnosis and treatment of these rare neuromuscular disorders., NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [NS6277]; German Research Foundation (DFG) (Emmy Noether Arbeitsgruppe), The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Genetic studies performed in AGE's laboratory were supported by NIH Grant NS6277. SC is funded by the German Research Foundation (DFG) (Emmy Noether Arbeitsgruppe).

In neonates supraphysiological oxygen therapy has been demonstrated to cause neuronal death in hippocampus, prefrontal cortex, parietal cortex, and retrosplenial cortex. There is a need for the detection of novel neuroprotective drugs. Neuroprotective effects of lacosamide or memantine have been demonstrated in adult patients with ischemia, trauma and status epilepticus. The effects in immature brains may be different. This study aimed to evaluate neuroprotective effects of lacosamide and memantine treatment in a hyperoxia-induced brain injury model in immature rats. This study was performed in the Animal Experiments Laboratory of Dokuz Eylul University Faculty of Medicine. Neonatal Wistar strain rat pups were exposed to hyperoxia (80% oxygen + 20% nitrogen) for five days postnatally. They were divided into five groups; hyperoxia + lacosamide, hyperoxia + memantine, hyperoxia + lacosamide and memantine, hyperoxia + saline, control groups. After termination of the experiment, brain tissues were examined. Neuron counting in examined regions were found to be higher in hyperoxia + memantine and hyperoxia + lacosamide and memantine groups than hyperoxia + saline group. The presence of apoptotic cells evaluated with TUNEL and active Caspase-3 in hyperoxia + memantine and hyperoxia + lacosamide and memantine groups were found to be lower compared to hyperoxia + saline group. This study demonstrates that neuron death and apoptosis in newborn rat brains after hyperoxia is reduced upon memantine treatment. This is the first study to show the effects of memantine and lacosamide on hyperoxia-induced damage in neonatal rat brains.

Acute cerebellitis is one of the most common cerebellar disorders and occurs due to para-infectious, post-infectious, or post-vaccination cerebellar inflammation. Herpes simplex virus-1 (HSV-1) is known as a common infectious cause of sporadic encephalitis. Cerebellar involvement of HSV-1 is rare and almost always associated with meningoencephalitis. To date, HSV-1 has been identified as the cause of acute isolated cerebellitis in only two patients. Here we report another case of isolated acute cerebellitis caused by HSV-1 in a 20-month-old boy.

Aim: This is a unique study that aimed to determine anemia and inflammatory status in simple febrile seizure vs complex febrileseizure patients. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are positively correlated with inflammatory markersincluding TNF alpha and IL-6. They are practical, inexpensive, and valuable tools for evaluating inflammation.Materials and Methods: Patients presenting with first febrile seizures were enrolled retrospectively. We investigated hemoglobin,hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration and red blood cell distribution width valuesand white blood cell count, neutrophil, lymphocyte count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean plateletvolume, C - reactive protein.Results: Our study showed that higher neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and lower mean platelet volumevalues in complex febrile seizure cases than simple febrile seizure cases. We determined cut-off values for neutrophil/lymphocyteratio, platelet/lymphocyte ratio, and mean platelet volume of 2.5, 10523.3, and 7.3 respectively.Conclusion: High neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and low mean platelet volume values can help distinguishsimple febrile seizure and complex febrile seizure patients and predict the clinic. The optimal cut-off values that we determined mayguide clinicians.

Bayram E, Yis U, Paketci C, Okur D, Polat I, Cakmakci H, Hiz S, Anlar B. Changes of primary headache related white matter lesions in pediatric patients. Turk J Pediatr 2018; 60: 380-384. We aimed to describe the long-term prognosis of white matter lesions detected on magnetic resonance imaging in children with primary headache. Children who were admitted with the complaint of headache and had nonspecific white matter lesions on magnetic resonance imaging were included in the study. The clinical findings of the patients were reinvestigated using the same magnetic resonance imaging scanner and acquisition protocol after at least a two year period. Magnetic resonance imaging results of the patients were documented in detail. Findings of the baseline and follow-up studies were compared with each other by the same radiologist. Among the 11 patients, 8 ( 72.7%) were male and 3 (27.3%) were female. Mean age of patients at the time of second imaging was 12.9±2.3 years. Eight (72.7%) had migraine without aura, 1 (9.1%) had tension-type headache and 2 (18.2%) had migraine with aura. The mean clinical follow-up period of the patients was 4.31±1.31 years. All patients had low headache frequency on the last control visit when compared to the first clinical findings. The follow-up magnetic resonance imaging studies showed two newly developed white matter lesions in two patients who had migraine without aura and the white matter lesions disappeared in the patient who had tension-type headache, compared to the baseline neuroimaging. Findings of the baseline and long-term follow-up magnetic resonance imaging studies of the patients with primary headache showed no significant changes in terms of the location, size and laterality. Repeated neuro-imaging studies are not warranted in the absence of the progression in clinical findings.

Despite the significant advancements in perinatal care, it is not clear whether or not the neurodevelopmental outcome in children with intraventricular hemorrhage (IVH) has improved in parallel with the declining incidence of periventricular- IVH. In this study, we aimed to assess the periventricular-IVH-induced mortality and morbidity rates, as well as the short-term neurodevelopmental outcomes in premature infants. Two hundred and sixty five patients who were admitted between September 2005 and May 2006 were investigated for periventricular-IVH. Sixty-six patients with periventricular-IVH were compared with 66 premature infants who were not associated with hemorrhage. Of the periventricular-IVH diagnosed premature infants, 59% were born at or before week 32, 61% had a body weight below 1500 g, and 24.9% had hemorrhage. In cases with periventricular-IVH, the rates of premature retinopathy and periventricular leukomalacia were significantly high ( P 0.05) while the relation between periventricular-IVH and neuromotor developmental retardation was significant ( P< 0.05). The outcome was poorer as the grade of bleeding increased ( P< 0.05). As a conclusion, regardless of risk factors, periventricular-IVH is an important early indicator of neurodevelopmental retardation, and those cases having such condition should be always assessed with a neurodevelopmental evaluation. The detection of neurodevelopmental retardation in short term with appropriate educational strategy could be beneficial for long-term outcome.

Rotavirus is a leading cause of gastroenteritis in children under 5 years of age. It is known that neurological manifestations like seizures, encephalopathy and encephalitis can rarely be seen due to rotavirus infections. Cerebellar involvement is extremely rare. We present an uncommon neurological manifestation of rotavirus infection in a 4-year-old Turkish child who presented with hypotonia, reduced consciousness and mutism. Magnetic resonance imaging revealed diffusion abnormalities in the splenium of corpus callosum and nucleus dentatus bilaterally. She was diagnosed with rotavirus cerebellitis. She improved well with dexamethasone and intravenous immunoglobulin but still has dysarthria and poor fine motor coordination.

Ya­z›fl­ma­Ad­re­si/Ad­dress­for­Cor­res­pon­den­ce:­Samed Ordu Haseki Egitim ve Arastirma Hastanesi, Ortopedi Klinigi, Istanbul, Turkiye GSM.: +90 505 629 12 49 E-pos ta: s_ordu@hotmail.com Gelifl­Tarihi/Received:­30 Eylul 2013­Ka­bul­Ta­ri­hi/Ac­cep­ted:­4 Ocak 2014 Haseki T›p Bulteni, Galenos Yay›nevi taraf›ndan bas›lm›flt›r. The Medical Bulletin of Haseki Training and Research Hospital, published by Galenos Publishing. Dizin Medial Kompartman Osteoartritinde Unikondiler Diz Artroplastisi Uygulanan Hastalarin Kisa Donem Sonuclari Short-Term Results of Medial Unicondylar Knee Arthroplasty

Oxygen therapy used in the treatment of perinatal hypoxia induces neurodegeneration in babies with immature antioxidant mechanisms. Zonisamide is a new antiepileptic drug used in childhood intractable seizures. Many studies demonstrated its neuroprotective effects. There is no study evaluating its effect on hyperoxic brain injury. The aim of this study was to investigate the neuroprotective effect of zonisamide on hyperoxia-induced neonatal brain injury. A total of 21 Wistar rat pups were used. The animals were divided into three groups: control group, hyperoxia group, and zonisamide-treated group. The zonisamide-treated group received an intraperitoneal injection of zonisamide. Zonisamide significantly preserved the number of neurons in CA1 and dentate gyrus parts of hippocampus, prefrontal, and parietal cortex. Zonisamide treatment also decreased the number of apoptotic neurons in all examined parts of hippocampus, prefrontal, and parietal cortex. We suggest that zonisamide treatment may be used as a neuroprotective agent in hyperoxic brain injury.

Aim We aimed to describe the efficacy and safety of levetiracetam in paediatric patients receiving chemotherapy for haematologic disorders. Methods Children with haematologic disorders who were receiving chemotherapy agents and developed seizure during treatment and treated with levetiracetam were included in the study. The clinical data of the patients were retrospectively evaluated. Primary haematologic diagnosis, chemotherapeutic agents, age at first seizure, seizure type, interictal electroencephalography findings, magnetic resonance imaging findings, response to the levetiracetam treatment, dose of levetiracetam, levetiracetam side effects and treatment period were recorded. Results Ten patients with a mean age 12.4 ± 2.96 years were included in the study. Possible triggering factors for seizures were chemotherapeutic agents in 60% (n = 6), posterior reversible encephalopathy syndrome in 20% (n = 2) and central nervous system involvement of the primary disease in 20% (n = 2). Nine patients received levetiracetam monotherapy, and one patient received levetiracetam that was added on oxcarbazepine due to the intractable seizures. The mean duration of antiepileptic treatment that overlapped with chemotherapy was 7.3 ± 3.5 months. Nine patients (90%) were seizure free after levetiracetam monotherapy, and one patient (10%) had ≥50% seizure reduction after levetiracetam who was previously treated with oxcarbazepine. No side effects were observed for levetiracetam during treatment. Conclusion Levetiracetam treatment is safe and effective to prevent seizures in children receiving chemotherapy for haematologic disorders.

Metabolic myopathies due to disorders of lipid metabolism are a heterogeneous group of diseases. Newborns may present with hypotonia and convulsions, while progressive proximal muscle weakness or recurrent episodes of muscle weakness accompanied by rhabdomyolysis/myoglobinuria may be seen in older ages. There is little knowledge on detection of disorders of lipid metabolism by acylcarnitine profile (ACP) analysis by tandem mass spectrometry outside the neonatal period particularly in cases with recurrent rhabdomyolysis first presenting in adolescence and adulthood. Two adolescent female cases presented with episodes of rhabdomyolysis and muscle weakness. A 13-year-old patient had five episodes of rhabdomyolysis triggered by infections. Tandem mass spectrometry was normal. A 16-year-old female patient was hospitalized eight times due to recurrent rhabdomyolysis. Increased levels of C14:2, C14:1, and C14 were determined in tandem mass spectrometry. Final diagnoses were carnitine palmitoyltransferase II (CPT II) deficiency and very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. Increased serum levels of long-chain acylcarnitine can guide to the diagnosis of lipid metabolism disorders. Serum ACP should be performed before enzyme assay and genetic studies.

Amaç: Anatomik olarak derin yerleşimli ve rijit olan kalça eklemi ve çevresinin patolojilerinin tanısı ve tedavisinde kalça artroskopisinin yeri irdelendi ve klinik tecrübelerimiz paylaşıldı. Gereç ve Yöntem: 2011 ve 2012 yılları arasında kliniğimize aksama ve kasıkta ağrı nedeni ile başvuran kalça artroskopisi yapılan hastalar değerlendirildi. Ortalama yaş 35.8 (alt-üst sınır: 17-58)yıl olan olguların üçü bayan, 12’si erkek 15 olgu değerlendirildi. Olguların ameliyat öncesi ve sonrası Harris kalça skoruna bakıldı. Bulgular: Olguların ortalama Harris kalça skoru ameliyat öncesi 62.7 (54-86) iken, ameliyat sonrası 92.5 (82-100) olarak saptandı. Üç hastamızda CAM tipi sıkışma saptanıp traşlandı, beş hastada labrum yırtığı saptanıp ikisi dikildi, diğerleri debride edildi. Bir hastada osteokondral lezyon(OCD) saptanıp ters mozaikoplasti yapıldı. Bir hastada lokalize femur başı avasküler nekroz saptanarak anterior mini açık mozaikoplasti yapıldı. İki hastada eklem içinden serbest cisim, bir hastada eklem içi mermi çıkarıldı. İki hastada eklem içi patoloji saptanmadı. Sonuçlar: Kalça artroskopisi eklem içi ve çevresindeki patolojilerin tanı ve tedavisinde deneyimli ellerde yapıldığı zaman iyi sonuçlar veren minimal invaziv bir tanı ve tedavi yöntemidir. Tekniğin başarısı yüksek olmakla birlikte nörojenik komplikasyonlar açısından cerrah portal yerleşiminde dikkatli olmalı, traksiyon süresini kısa tutmaya çalışmalıdır. Objective: Hip is a relatively rigid and deep located joint. The role of arthroscopy in diagnosis and treatment of hip and surrounding tissue pathologies has been evaluated along with our clinical experience. Material and Method: Fifteen hip arthroscopy cases who had admitted to our clinic with antalgic limp and groin pain between 2011 and 2012 were evaluated. Mean age was 35.8 (17-58) years. Three of the patients were female and 12 were male. Preoperative and postoperative Harris hip scores were recorded. Results: Mean preoperative Harris Hip Score of the cases was 62.7 (54-86) and mean postoperative Harris Hip score was 92.5 (82-100). In three patients CAM type femoro-acetabular impingement was diagnosed and excessive portion of the femoral neck was shaved. In five patients, labral tears were detected. Two were repaired and three were debrided. One patient was diagnosed with osteochondral lesion and treated with reverse mosaicoplasty. Localised avascular necrosis of the femoral head was diagnosed in one patient and anterior mini-open mosaicoplasty was performed. Loose bodies were excised in two patients and intraarticular bullet was extracted in one patient. In two patients, no intraarticular pathology was detected. Conclusion: When performed by experienced surgeons, hip arthroscopy is a minimal invasive diagnostic and treatment method which has successful results in intraarticular and periarticular hip disorders. Despite the high success rate, neurologic compromise must be avoided by paying meticulous attention in portal selection and by keeping the traction time as short as possible.

Aim We aimed to describe the prevalence and significance of white matter lesions detected on magnetic resonance imaging (MRI) in children with headache. Material and Methods Children who were admitted with the complaint of headache and had neuroimaging between December 2007 and June 2012 were included in the study. The clinical and neuroimaging data of the patients were retrospectively evaluated. MRI results of the patients were documented in detail. The patients with non-specific white matter lesions were called for a control visit, and current status of headache and neurological findings were determined. Results A total of 941 patients were included in the study. Sixty-one percent of the patients received cranial neuroimaging. 8.2% had only cranial computed tomography (CT), 7.5% had cranial CT and cranial MRI, and 84.3% had only cranial MRI. 22.1% of the patients had abnormal cranial MRI findings. The rate of incidental non-specific white matter changes detected in our study group was 23/527 (4.4%). Among the 23 patients, 12 (52.2%) were male and 11 (47.8%) were female. Fourteen (60.9%) had migraine without aura, 8 (34.8%) had tension-type headache, and 1 (4.3%) had migraine with aura. Mean age of patients at the time of imaging was 12.1 ± 3.4 years (range 4.0-16.0 years). All patients with non-specific white matter changes on MRI showed normal psychomotor development, and there was no history of seizures or head trauma. The physical and neurological examinations of all patients were normal. The mean clinical follow-up period of the patients was 16.8 ± 17.3 months (range 6-80 months). No patients showed neurological deterioration during the follow up. The white matter lesions were supratentorial in all patients. The mean size of the lesions was 5.1 ± 4.5 mm (minimum, 2 mm; maximum, 24 mm). Repeated radiological evaluations were performed in 11 (47.8%) of the patients. No new white matter lesions were detected in control MRI during follow up. Conclusion Non-specific incidental white matter changes may be seen in children with headache. For normal clinical follow up, in the absence of evident benefits from repeated imaging studies, we suggest that repeated imaging studies are not warranted in every patient and should be tailored according to clinical course.

Arthroscopic rotator cuff repair Purpose: Clinical and functional arthroscopic repair results of rotator cuff tears which have been diagnosed both radiographically and clinicaly have been evaluated. Patients And Method: 26 patients treated with arthroscopic rotator cuff tear repair have been studied. Functional scores at the last follow-up were recorded. Mean age was 52.85±8.39 (range 3871), Mean follow up time was 36.6±16.6 (range 14-56). 10 patients were (38.5%) male and 16 (61.5%) were female. Preoperatively patients were examined radiologically with X ray and MR and clinically with constant score. Postoperative constant scores were recorded. Results: 18 (69.2%) of the effected shoulders were on the right side and 8 (30.2%) were on the left side. 3 (13.5%) of the patients went through acromioplasty. 76.9 % of the 26 patients had only supraspinatus tear where as in 23.1% of the patients concomitant infraspinatus tear was detected. Ethiologically three (11.5%) patients had history of shoulder trauma. Preoperative mean constant score was 52.89 (33-64) and postoperative mean constant score was 82±11.7 (56-100). All patients had significant increase in constant scores (p=0.000). Eight (30.7%) patients scored excellent, 10 (38.4%) patients good, seven (26.8%) patients fair and one (3.8%) patient bad . Conclusion: In selected cases, when the tear is not massive, arthroscopic rotator cuff repair may be the preferred treatment method becouse of its predictable good results and relatively less complication rate. Routine acromioplasty or subacromial decompression are not recommended.

Guillain-Barré syndrome (GBS) and transverse myelitis may occur coexistently in the pediatric population. This may be explained by a shared epitope between peripheral and central nervous system myelin. Coexistent transverse myelitis, myositis, and acute motor neuropathy in childhood have not been previously described. We describe a 14-year-old female patient with transverse myelitis, myositis, and GBS following Mycoplasma pneumoniae infection. She presented with weakness and walking disability. Weakness progressed to involve all extremities and ultimately, she was unable to stand and sit. Based on the clinical findings, a presumptive diagnosis of myositis was made at an outside institution because of high serum creatine kinase level. The patient was referred to our institution for further investigation. Magnetic resonance imaging of spine revealed enhancing hyperintense lesions in the anterior cervicothoracic spinal cord. The electromyography revealed acute motor polyneuropathy. Serum M. pneumoniae IgM and IgG were positive indicating an acute infection. Repeated M. pneumoniae serology showed a significant increase in Mycoplasma IgG titer. The patient was given intravenous immunoglobulin for 2 days and clarithromycin for 2 weeks. She was able to walk without support after 2 weeks of hospitalization. This paper emphasizes the rarity of concomitant myositis, transverse myelitis, and GBS in children.

Shapiro syndrome is an extremely rare condition consisting the clinical triad of recurrent hypothermia, hyperhydrosis and agenesis of the corpus callosum. On the other hand, reverse Shapiro's sydrome is characterized periodic hyperthermia and agenesis of the corpus callosum. Here, we describe a 3.5-year-old girl with complete agenesis of corpus callosum presenting with recurrent fever and vomiting. She also had hypothermia attacks with accompanying diaphoresis. To the best of our knowledge, there is no described case with episodes of hyperthermia, hypothermia, and vomiting associated with agenesis of the corpus callosum. Recurrent vomiting may be a newly defined symptom associated with these syndromes.

Structural vascular lesions are the biggest risk factor for spontaneous intracranial hemorrhage in children and many concomitant factors can trigger parenchymal hemorrhage. If neonatal intraventricular hemorrhage and traumatic lesions are excluded, cerebral hemorrhage is more common than ischemic infarct in childhood. Atherosclerotic disease, ischemic heart disease and hemorrhages caused by hypertension are frequently seen in adults but infectious and inflammatory causes of stroke is more common in children. Although primary Epstein Barr virus (EBV) infection usually causes infectious mononucleosis in patients who developed neurologic complications of EBV infection, usually clinical findings of infectious mononucleosis can not be detected. In this report, we presented a 13-year-old girl with acute hemorrhagic stroke accompanied by central venous angioma and concomitant asymptomatic acute EBV infection. Though rarely seen infectious etiology of stroke should be considered in childhood stroke cases.

The aim of this study is to investigate the relationship between body composition, anthropometry, and motor scales in patients with Duchenne muscular dystrophy (DMD). Twenty six patients with DMD were evaluated by Expanded Hammersmith Functional Motor Scale (HFMSE), gross motor function classification system (GMFCS), multifrequency bioelectrical impedance analysis, and anthropometric measurements. Seventeen healthy children served as control group. There were 26 patients with a mean age of 9.5 +/- A 4.8 years. Ages and anthropometric measurements did not differ between groups. Of the 26 patients, nine were level I, seven were level II, two were level III, seven were level IV, and one was level V, according to the GMFCS. Despite the similar percentage of total body water, extracellular water/intracellular water ratio was significantly elevated in DMD patients (p = 0.001). Increased values of fat percentage and body fat mass index (BFMI) correlated positively with elevated GMFCS levels (r = 0.785 and 0.719 respectively). Increased fat-free mass index (FFMI) correlated negatively with elevated GMFCS levels (r = -0.401). Increased fat percentage and BFMI correlated negatively with HFMSE scores (r = -0.779 and -0.698, respectively). Increased values of FFMI correlated positively with HFMSE scores. There was also a negative correlation between increased skin fold measurements from triceps and scapula and HFMSE scores (r = -0.618 and -0.683, respectively). Increased skin fold values from the same regions correlated positively with elevated GMFCS levels (r = 0.643 and 0.712, respectively). Significant body composition changes occur in patients with DMD. Anthropometric and multifrequency bioelectrical impedance analyses measurements show good correlation between motor function scales. These results may also be helpful to evaluate the effects of new treatment strategies.

Objectives: To determine the neurodevelopmental morbidityof preterm infants with periventricular- intraventricularhemorrhage, at the age of 4.Materials and methods: The patients at the age of 4were evaluated through neurologic examination and motorassessment by a pediatric neurologist and Denver IIDevelopmental Screening Test by a psychologist. Theresults were compared with Denver II DevelopmentalScreening Test results which had been made at 3-6 and6-12 months.Results: Patients with grade ІІІ-ІV Periventricular-IntraventricularHemorrhage had significantly lower DenverII Developmental Screening Test results at the age of 4,compared with grade І-ІІ Periventricular-IntraventricularHemorrhage group. Similarly, ≤ 32 weeks patients hadsignificantly lower Denver II Developmental ScreeningTest at the age of 4 when compared with > 32 weeks patients.Conclusions: Children who were born ≤ 32 gestationalweeks and/or patients with grade ІІІ-ІV periventricularintraventricularHemorrhage have an increased risk ofneurologic impairment. All premature infants should beevaluated by Denver II Developmental Screening Test inearly childhood period of life. J Clin Exp Invest 2012; 3(3):326-330Key words: Prematurity, periventricular hemorrhage, intraventricularhemorrhage

In this retrospective study, the impact of age, amputation level and the cause of amputation were examined using the Hospital Anxiety and Depression Scale (HADS) and Medicare K scores of amputees with unilateral lower-limb amputation.In total, 135 patients with unilateral transfemoral (TF) or (TT) transtibial amputations were examined. All data were collected using questionnaires that were either self-administered or administered during an interview. The HADS was developed as a self-reporting questionnaire to detect adverse anxiety and depressive status. K code is used to describe the functional abilities of amputees.The mean age at the time of surgery was 52.79 ± 13.08 years. The mean time since amputation was 59.20 ± 24.41 months for TT, and 60.89 ± 22.09 months for TF amputation. The HADS-A scores of the transfemoral amputation group were determined as significantly high compared to those of the transtibial group (p0.05). The K index of the group aged 35 years and below was significantly higher than that of the other groups (p 0.002, p 0.001, p0.01).The data show higher HADS-A scores with traumatic transfemoral amputation. Therefore, adequate psychiatric evaluation and rehabilitation should be applied to all amputees, especially in cases of young, traumatic, transfemoral amputations.Level 3, retrospective comparative cohort study.

The most frequently treated injuries, representing approximately 82% of all clavicular fractures, involve the midshaft clavicle. Historically, most acute displaced midshaft clavicular fractures were treated nonsurgically. However, the outcomes of nonsurgical treatment have recently been thought to be not as good as expected in the past, and the trend is to treat these fractures surgically. The goal of this study was to evaluate the short-term clinical outcomes of Robinson type 2B2 clavicular fractures treated conservatively vs with locked plate fixation. Among 59 patients included in the study, 30 patients (mean age, 45±13.7 years; range, 30–62 years) treated conservatively were designated as group A, and 29 patients (mean age, 38.8±11.1 years; range, 20–60 years) treated with locked plate fixation were designated as group B. All patients were evaluated using Oxford and Constant scoring systems at final follow-up. Mean follow-up was 18 months (range, 12–24 months). In group A, mean Constant score was 70.5±15.1 (range, 98-43) and mean Oxford score was 46.6±1.3 (range, 49-44) at final follow-up. In group B, mean Constant score was 89.2±8 (range, 100-77) and mean Oxford score was 46.5±1.2 (range, 48-44) at final follow-up. Callus was detected radiographically in both groups at 6-week follow-up. Patients in groups A and B started active range-of-motion exercises at weeks 6 and 3 after treatment, respectively. Locked plate fixation of Robinson type 2B2 clavicular fractures can be the first treatment option because of good clinical results, low complication rates, and good cosmesis. [ Orthopedics. 2016; 39(2):e276–e279.]

Objectives: Because of the difficulty in confirming childhood tuberculosis, the World Health Organization developed a scale based on clinical parameters. In our study the utility of this scale was evaluated. Materials and methods: Patients whom were admitted to the Dr. Behçet Uz Children Hospital due to the complaints of chronic cough, weight loss and/or close household contact with adult tuberculosis were included. Patients were evaluated in according to the history, physical examination and/or chest radiography, PPD and the results of the cultures obtained from fasting gastric juice/sputum and implanted on Bactec and Lowenstein-Jensen culture medium. Results: Totally, 108 patients were included in this study. According to World Health Organization criteria, 24 cases (22.2%) were classified as suspicious, 80 cases (74.1%) as probable and 4 of them (3.7%) as definite tuberculosis. Lymphodenopathy and atelectasis in chest radiography and in addition lymphodenopathy, bronchiectasis and calcification in thorax computed tomography were more frequently seen in the PPD positive group compared with the PPD negative group (p=0.012, p=0.02). Anti-tuberculosis treatment were not given for twenty four patients who were included in suspicious group and tuberculosis were not seen in any of these patients during their six month follow up period. During the six months follow-up of the probable and definite tuberculosis groups, clinical findings improved in all of the patients who were treated. Conclusion: World Health Organization diagnosis criteria were considered to be useful for the diagnosis of tuberculosis in children. J Clin Exp Invest 2012; 3(2): 255-259, Amaç: Çocuklarda tüberküloz (TB) tanısının doğrulanmasındaki güçlükler nedeniyle Dünya Sağlık Örgütü, klinik parametrelere dayanan bir skala geliştirmiştir. Çalışmamızda bu skalanın kullanılabilirliği değerlendirilmiştir. Gereç ve yöntem: Dr. Behçet Uz Çocuk Hastanesi\'ne kronik öksürük, kilo kaybı ve/veya erişkin tüberkülozlu birey ile aile içi temas nedenleri ile başvuran hastalar çalışmaya dahil edilmişlerdir. Hastalar anamnez, fizik muayene, akciğer grafisi ve/veya toraks bilgisayarlı tomografi, PPD ve açlık mide suyu ya da balgamdan alınan örneklerin Bactec ve Lövenstein- Jensen kültür vasatı sonuçlarına göre değerlendirildi. Bulgular: Çalışmaya 108 hasta dahil edilmiştir. Dünya Sağlık Örgütü tanı kriterlerine göre olguların 24\'ü (%22,2) kuşkulu, 80\'i (%74,1) olası, 4\'ü de (%3,7) kesin tüberküloz olarak sınıflandırıldı. PPD pozitif olan grupta, akciğer grafisinde lenfodenopati ve atelektazinin, toraks bilgisayarlı tomografi\'de ise lenfodenopati, bronşektazi ve kalsifikasyonun, PPD negatif olan gruba göre daha sık görüldüğü saptandı (p=0,012, p=0,02). Kuşkulu TB grubunda yer alan yirmi dört hastaya anti-tüberküloz tedavi verilmemiş ve hastaların hiçbirisinin altı aylık tedavisiz izlemleri sırasında tüberküloz hastalığı gelişmedi. Olası ve kesin tüberküloz grubunda olan ve anti-tüberküloz tedavi alan hastaların altı aylık izlemi sonucunda, olguların hepsinin klinik bulgularının gerilediği görüldü. Sonuç: Dünya Sağlık Örgütü tanı kriterlerinin çocuklarda tüberküloz tanısı için kullanışlı olduğu düşünüldü.

Acute isolated neurological syndrome is the most common symptom in multiple sclerosis but can also be the only feature or first manifestation in antiphospholipid syndrome, systemic lupus erythematosus and neuro-Behcet’s disease. Patients with demyelinating features may be given the false label of multiple sclerosis. Neuro-Behcet’s disease is an inflammatory disorder where the magnetic resonance imaging findings and clinical course may mimic multiple sclerosis. Here we present a 13 year-old girl with neuro-Behcet’s disease in terms of rarity and review of the differential diagnosis of demyelinating features.

Aicardi syndrome (AS) is an X-linked inherited disorder characterized by infantile spasms, chorioretinal lacunae, and agenesis or hypogenesis of the corpus callosum. The syndrome is more frequently seen in females but is observed in XXY male patients. Central nervous system, ocular, and costovertebral malformations may also seen in AS. Eye findings are of a considerable diagnostic importance; the chorioretinal lacunae are pathognomonic for AS and are generally bilateral. The outcome of the disease is generally severe, with a high mortality rate and poor developmental outcome. It is not clear which characteristics of the syndrome are related to a good prognosis in terms of psychomotor development, epileptic seizures, and survival. The purpose of this report was to demonstrate the spectrum of the clinical findings and the course of AS in two Turkish patients with different ocular and cranial MRI findings.

Aim There is a need for an objective assessment scoring system to evaluate the effectiveness of prophylactic drugs in paediatric migraine, and the aim of this study was to evaluate the Paediatric Migraine Disability Assessment Score (PedMIDAS). Methods We recruited 88 children aged between 6 and 17 years of age with migraine. The 53 children in the treatment group were divided into three groups according to the prophylactic drug they received topiramate, flunarizine and propranolol and assessed using PedMIDAS before the start of treatment and 3 and 6 months after treatment. The 35 patients in the control group did not receive prophylactic treatment and were assessed with PedMIDAS on three occasions, 3 months apart. Results Topiramate, propranolol and flunarizine treatments significantly decreased PedMIDASs and were shown to be effective in improving the patients’ quality of life. Topiramate and propranolol were more effective than flunarizine. The number of days on analgesic treatment significantly decreased in the patients who had received topiramate and propranolol treatments (p 0.05). Conclusion The PedMIDAS scoring system is useful in evaluating the efficacy of prophylactic therapy in paediatric migraine. Topiramate and propranolol lowered the PedMIDASs better than flunarizine.

Aim The aim of this study was to evaluate the relationship between clinical and cranial magnetic resonance imaging findings in patients with corpus callosum (CC) abnormalities. Patients and Methods Between September 2010 and March 2012, patients with developmental CC abnormalities were included in the study. CC abnormalities were classified as total agenesis, partial agenesis, and callosal hypoplasia. Regarding the groups, the association between radiological abnormalities and clinical findings were evaluated. Results A total of 62 patients (32 females [51.6%] and 30 males [48.4%]) with a mean age of 18.0 ± 32.1 months were enrolled in the study. Of them, 20 patients (32.3%) had total agenesis, 9 patients (14.5%) had partial agenesis, and 33 (53.2%) patients had hypoplasia of the CC. Thirty-five cases (56.7%) had abnormal physical examination, 47 cases (75.8%) had abnormal neurological examination, and 42 cases (67.7%) had psychomotor retardation. There were no significant differences between groups regarding physical examination, psychomotor retardation, seizures, or microcephaly. Seizures, psychomotor retardation, and neurological abnormalities were significantly more frequent in patients with associated other radiological abnormalities. Posterior segment of the CC was significantly thinner in patients with psychomotor retardation and the anterior part of the CC thinner in patients with abnormal physical examination. Patients with total agenesis were more prone to seizures at an early age than patients with partial agenesis or hypoplasia. Conclusion The neurological prognosis of patients with CC abnormalities is poorer in patients with an associated neuroradiological abnormality. Early development of seizures may be observed in cases with total agenesis of the CC.

PubMedID: 24731844 Background To evaluate clinical, genetic, and radiologic features of our patients with muscle-eye-brain disease. Methods The data of patients who were diagnosed with muscle-eye-brain disease from a cohort of patients with congenital muscular dystrophy in the Division of Pediatric Neurology of Dokuz Eylül University School of Medicine and Gaziantep Children's Hospital between 2005 and 2013 were analyzed retrospectively. Results From a cohort of 34 patients with congenital muscular dystrophy, 12 patients from 10 families were diagnosed with muscle-eye-brain disease. The mean age of the patients was 9 ± 5.5 years (2-19 years). Mean serum creatine kinase value was 2485.80 ± 1308.54 IU/L (700-4267 IU/L). All patients presented with muscular hypotonia at birth followed by varying degrees of spasticity and exaggerated deep tendon reflexes in later stages of life. Three patients were able to walk. The most common ophthalmologic and radiologic abnormalities were cataracts, retinal detachment, periventricular white matter abnormalities, ventriculomegaly, pontocerebellar hypoplasia, and multiple cerebellar cysts. All of the patients had mutations in the POMGNT1 gene. The most common mutation detected in 66% of patients was c.1814 G > A (p.R605H). Two novel mutations were identified. Conclusions We suggest that muscle-eye-brain disease is a relatively common muscular dystrophy in Turkey. It should be suspected in patients with muscular hypotonia, increased creatine kinase, and structural eye and brain abnormalities. The c.1814 G > A mutation in exon 21 of the POMGNT1 gene is apparently a common mutation in the Turkish population. Individuals with this mutation show classical features of muscle-eye-brain disease, but others may exhibit a milder phenotype and retain the ability to walk independently. Congenital muscular dystrophy patients from Turkey carrying the clinical and radiologic features of muscle-eye-brain disease should be evaluated for mutations in POMGNT1 gene. © 2014 Elsevier Inc. All rights reserved.

A 14-year-old boy presented with acute visual loss due to cortical blindness. Two weeks after the visual symptoms, the patient developed behavioral abnormalities. Brain magnetic resonance imaging (MRI) revealed hyperintense lesions at parieto-occipital lobes on T2-weighted and fluid attenuated inversion recovery images. Sleep and awake electroencephalography (EEG) were normal, but diazepam administration revealed bilateral periodic synchronous complexes occurring every 20 to 30 seconds. Elevated measles antibody titers in cerebrospinal fluid confirmed the diagnosis of subacute sclerosing panencephalitis. We conclude that visual loss due to cortical blindness is an important finding of subacute sclerosing panencephalitis. Diazepam administration during EEG should be a part of investigation in cases with unexplained cortical blindness.

Kabuki syndrome (KS) comprises a unique facial pattern with large palpebral fissures, malar flattening and everted lower eyelids, postnatal growth deficiency, skeletal anomalies, dermatoglyphic abnormalities, and mental retardation. Visceral anomalies such as congenital heart defects and urinary tract anomalies have also been reported.[1] KS was described independently by Niikawa et al.[2] and Kuroki et al.[3] A majority of cases have been reported from Japan,[4] but patients are found in other ethnic groups as well.[5,6] Neurologic anomalies are frequently reported for KS, although cortical dysplasia is uncommon. Here, we report a 5-year, 7-month-old female patient with KS who had perisylvian cortical dysplasia. To our knowledge, this is the first Turkish case of KS to present with unilateral perisylvian cortical dysplasia.

Although brachial plexus injury occurring during multitrauma is frequent in adults, it is rarely observed in childhood. The most common cause of pediatric traumatic brachial palsy is motor vehicle accidents followed by pedestrian struck. Generally, phrenic nerve palsy accompanying brachial plexus trauma is observed in 10% to 20% of cases, but it is overlooked because unilateral injuries are frequently asymptomatic. Severe unilateral phrenic nerve palsy accompanying brachial plexus avulsion is very rare. Here, we present a pediatric case of unilateral phrenic nerve palsy associated with respiratory distress and brachial plexus avulsion due to multitrauma.

Amaç: Tekrarlayan anterior omuz çıkığı tedavisinde yapılan artroskopik bankart tamiri sonuçları tartışıldı. Gereç ve Yöntem: Tekrarlayan omuz çıkığı nedeni ile artroskopik bankart tamiri yapılan 16 hasta değerlendirmeye alındı. Dört hasta bayan, 12 hasta erkekti. Tüm hastalara direkt radyografi ve manyetik rezonans görüntüleme yapıldı. Sonuçlar Rowe ve Constant skoru ile değerlendirildi. Bulgular: Ortalama çıkma sayısı 10.2, ortalama Rowe skoru 90.6 ve ortalama Constant skoru 94.3 bulundu. İki hastada eşlik eden süperior labral anterior ve posterior tamir yapıldı. Üç hastada Hill Sachs defekti, üç hastada ise glenoid kenarda defekt mevcuttu. Bir hastamızın ameliyattan 15 ay sonra yeni travma sonrası nüks omuz çıkığı görüldü; tekrar opere edildi. Bir hastamıza vida eklem içi penetrasyonu nedeni ile revizyon yapıldı. Ortalama takip süresi 32.6 aydı. Sonuç: Artroskopik Bankart tamirinin klinik sonuçları iyidir. Ameliyat öncesi çıkık sayısı fazla olan hastalarda revizyon cerrahisine ihtiyaç olabilir; dikkatli olunmalıdır. Objective: To analyze the results of arthroscopic Bankart repair for recurrent anterior shoulder dislocations. Material and Method: 16 patients who were performed arthroscopic Bankart repair due to recurrent anterior shoulder dislocation were included in the study. There were four females and 12 males. X ray and Magnetic resonans imaging was admitted for all patients. Results were evaluated according to Rowe and Constant scores. Results: The mean number of dislocations was 10.2, mean Rowe score was 90.6 and mean Constant score was 94.3. Concomitant superior labral anterior and posterior repair was performed for two patients. Three patients had Hill Sachs defects and three patients had defects on the glenoid rim. One patient was detected with traumatic redislocation 15 months after the operation and was reoperated. One patient was reoperated because of intraarticular penetration of the anchor. Mean follow up time was 32.6 months. Conclusion: Arthroscopic bancart repair has good clinical outcome. Increased number of preoperative dislocations may increase the frequency of redo surgery; this should be kept in mind for these patients.

BACKGROUND: To evaluate clinical, genetic, and radiologic features of our patients with muscle-eye-brain disease. METHODS: The data of patients who were diagnosed with muscle-eye-brain disease from a cohort of patients with congenital muscular dystrophy in the Division of Pediatric Neurology of Dokuz Eylul University School of Medicine and Gaziantep Children’s Hospital between 2005 and 2013 were analyzed retrospectively. RESULTS: From a cohort of 34 patients with congenital muscular dystrophy, 12 patients from 10 families were diagnosed with muscle-eyebrain disease. The mean age of the patients was 9 � 5.5 years (2-19 years). Mean serum creatine kinase value was 2485.80 � 1308.54 IU/L (700-4267 IU/L). All patients presented with muscular hypotonia at birth followed by varying degrees of spasticity and exaggerated deep tendon reflexes in later stages of life. Three patients were able to walk. The most common ophthalmologic and radiologic abnormalities were cataracts, retinal detachment, periventricular white matter abnormalities, ventriculomegaly, pontocerebellar hypoplasia, and multiple cerebellar cysts. All of the patients had mutations in the POMGNT1 gene. The most common mutation detected in 66% of patients was c.1814 G > A (p.R605H). Two novel mutations were identified. CONCLUSIONS: We suggest that muscle-eye-brain disease is a relatively common muscular dystrophy in Turkey. It should be suspected in patients with muscular hypotonia, increased creatine kinase, and structural eye and brain abnormalities. The c.1814 G > A mutation in exon 21 of the POMGNT1 gene is apparently a common mutation in the Turkish population. Individuals with this mutation show classical features of muscle-eye-brain disease, but others may exhibit a milder phenotype and retain the ability to walk independently. Congenital muscular dystrophy patients from Turkey carrying the clinical and radiologic features of muscle-eye-brain disease should be evaluated for mutations in POMGNT1 gene.