Diagnostic and Prognostic Value of Pentraxin 3, Interleukin-6, CRP, and Procalcitonin Levels in Patients with Sepsis and Septic Shock.

INTRODUCTION AND PURPOSE: In this prospective study, we aim to evaluate the effects of antibiotherapy on pentraxin-3 (PTX3), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in patients with sepsis and septic shock. MATERIALS AND METHODS: In our study, CRP, procalcitonin, IL-6, and PTX3 levels at initial and 48 hours of the antibiotherapy of patients who were admitted to the pediatric intensive care unit (PICU) with the diagnosis of sepsis and septic shock between June 2020 and March 2021 were compared. Patients were compared with the age-appropriate case-control group formed from the patients who received pre-operative routines to investigate the diagnostic value. RESULTS: CRP, IL-6, and PTX3 levels of the patients were significantly higher compared to controls (P < 0.05). After the 48th hour of treatment compared to initial CRP, lactate and PCT levels were significantly lower (P < 0.05). The IL-6 and PCT levels were significantly higher in patients with mortality than in surviving patients. Surviving patients showed a significant decrease in CRP level at the 48th hour. IL-6 levels of patients with septic shock were significantly higher than those with sepsis (P = 0.010; P < 0.05). In the diagnosis of septic shock, the area under curve was 0.785 for IL-6 and the standard deviation was 0.09 (P = 0.002, cut-off value, >32 pg/mL, 88.9% sensitivity, 65.6% specifity). CONCLUSION: The results of this study indicated that IL-6 level is an appropriate biomarker with high specificity in the diagnosis of sepsis and septic shock and in evaluating the response to treatment and determining the prognosis.

Bony cochlear nerve canal and internal auditory canal measures predict cochlear nerve status.

OBJECTIVES: The bony cochlear nerve canal is the space between the fundus of the internal auditory canal and the base of the cochlear modiolus that carries cochlear nerve fibres. This study aimed to determine the distribution of bony labyrinth anomalies and cochlear nerve anomalies in patients with bony cochlear nerve canal and internal auditory canal atresia and stenosis, and then to compare the diameter of the bony cochlear nerve canal and internal auditory canal with cochlear nerve status. METHODS: The study included 38 sensorineural hearing loss patients (59 ears) in whom the bony cochlear nerve canal diameter at the mid-modiolus was 1.5 mm or less. Atretic and stenotic bony cochlear nerve canals were examined separately, and internal auditory canals with a mid-point diameter of less than 2 mm were considered stenotic. Temporal bone computed tomography and magnetic resonance imaging scans were reviewed to determine cochlear nerve status. RESULTS: Cochlear hypoplasia was noted in 44 out of 59 ears (75 per cent) with a bony cochlear nerve canal diameter at the mid-modiolus of 1.5 mm or less. Approximately 33 per cent of ears with bony cochlear nerve canal stenosis also had a stenotic internal auditory canal and 84 per cent had a hypoplastic or aplastic cochlear nerve. All patients with bony cochlear nerve canal atresia had cochlear nerve deficiency. The cochlear nerve was hypoplastic or aplastic when the diameter of the bony cochlear nerve canal was less than 1.5 mm and the diameter of the internal auditory canal was less than 2 mm. CONCLUSION: The cochlear nerve may be aplastic or hypoplastic even if temporal bone computed tomography findings indicate a normal cochlea. If possible, patients scheduled to receive a cochlear implant should undergo both computed tomography and magnetic resonance imaging of the temporal bone. The bony cochlear nerve canal and internal auditory canal are complementary structures, and both should be assessed to determine cochlear nerve status.

Manubrio-stapedioplasty: new surgical technique for malleus and incus fixation due to tympanosclerosis.

OBJECTIVE: This paper reports the authors' technique of manubrio-stapedioplasty using glass ionomer cement for malleus and incus fixation due to tympanosclerosis. METHODS: A retrospective case review was conducted of five patients with conductive hearing loss (mean pre-operative air-bone gap of 42.75 dB) treated in a tertiary referral centre. The hearing results of a manubrio-stapedial bone cement ossiculoplasty technique, utilised on the five patients, were analysed. All cases were Wielinga and Kerr tympanosclerosis classification type 2 (attic fixation of the malleus-incus complex with a mobile stapes). The incus and head of the malleus were removed in all patients, and the manubrium was directly connected to the head of the mobile stapes using glass ionomer cement. Patients were evaluated in terms of pre- and post-operative audiometric results; hearing gain and post-operative air-bone gap were the main outcome measures. RESULTS: Mean post-operative air-bone gap was 5.25 dB. Four patients had an air-bone gap of less than 10 dB; the remaining patient had an air-bone of 12.50 dB. CONCLUSION: Manubrio-stapedioplasty is an effective method for ossicular reconstruction in cases of malleus and incus fixation due to tympanosclerosis.

New laryngoscope for endoscopic arytenoidectomies.

OBJECTIVE: During an endoscopic arytenoidectomy, an intubation tube must be elevated anteriorly with the laryngoscope to ensure an adequate surgical field. This paper describes a new laryngoscope that has a canal along the outer wall of the body and a ridge which runs along the canal. METHOD: Ten patients underwent endoscopic total arytenoidectomy using this new laryngoscope and 10 patients underwent the same operation using a regular laryngoscope. RESULTS: The duration of all operations ranged between 25 and 65 minutes, with a median duration of 42.5 minutes. The median duration with the new laryngoscope was 39 minutes, and that with the regular laryngoscope was 49 minutes; this difference was statistically significant (p < 0.05). CONCLUSION: This new laryngoscope shortened the duration of the endoscopic arytenoidectomy and facilitated the procedure by enlarging the surgical field. This new laryngoscope may be a beneficial surgical instrument for posterior endoscopic laryngeal operations.

Mothers' knowledge of young child development in a developing country.

BACKGROUND: Although interventions on child development target supporting mothers' relationships with their children, little is known about maternal knowledge of child development in developing countries. The purpose of this study was to determine maternal knowledge about child development in Turkey. METHODS: The Caregiver Knowledge of Child Development Inventory (CKCDI) developed for this study consisted of questions on when children begin to demonstrate developmental skills and when caregivers should provide opportunities for developmental stimulation. RESULTS: In total, 1200 mothers of children aged

Ophthalmo-acromelic syndrome: report and review.

The ophthalmo-acromelic syndrome of Waardenburg is an autosomal recessive trait comprising eye malformations ranging from true anophthalmia to mild microphthalmia with acromelic malformations. Some 29 affected individuals have been reported since Waardenburg's first report in 1935 [Waardenburg et al., 1961]. We report on a new case with bilateral anophthalmia and typical limb malformations. The patient also was found to have interruption of the inferior vena cava with azygos continuation as an additional finding. The previous reports are reviewed to elucidate the spectrum of the syndrome.