What Is the Important Point Related to Follow-Up Sonographic Evaluation for the Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip (DDH) is an important cause of childhood disability. Subluxation or dislocation can be diagnosed through pediatric physical examination; nevertheless, the ultrasonographic examination is necessary in diagnosing certain borderline cases. It has been evaluated routine sonographic examination of 2,444 hips of 1,222 babies to determine differences in both, developmental dysplasia and types of hips, and evaluated their development on the 3-month follow-up. Evaluating the pathologic “α” angles under 59, there was no statistically significant differences between girls and boys in both right (55.57 ± 3.73) (56.20 ± 4.01), (p = 0.480), and left (55.79 ± 3.96) (57.00 ± 3.84), (p = 0.160) hips on the 45th day of life. Routine sonographic examinations on the 45th day of life revealed that 51 of (66.2%) 77 type 2a right hips were girls and 26 (33.8%) were boys. The number of the right hips that develop into type 1 was 38 (74.5%) for girls and 26 (100%) for boys on the 90th day of life (p = 0.005). A total of 87 type 2a left hips included 64 girls (73.6%) and 23 boys (26.4%). In the 90th day control, 49 right hip of girls (76.6%) and 21 right hip of boys (91.3%) developed into type 1 (p = 0.126). In the assessment of both left and right hips, girls showed a significantly higher frequency in latency and boys showed significantly higher development in the control sonography. A total of 31 girls (2.5%) and 11 boys (0.9%) accounted for a total of 42 (3.4%) cases who showed bilateral type 2a hips in 1,222 infants. On the 90th day control, 26 girls (83.9%) and all 11 boys (100%) developed into type 1 (p = 0.156). The study emphasizes the importance of the sonographic examination on the 90th day of life. Results of the investigation include the data of sonographic screening of DDH on the 45th day, and also stress the importance of the 90th-day control sonography after a close follow-up with physical examination between 45th and 90th days of life.

Pulmonary Complications in Heart Transplant Recipients

BACKGROUND

Heart transplantation is an important therapeutic option for patients with end-stage disease, but is associated with major pulmonary complications.

PATIENTS AND METHODS

We retrospectively reviewed the posttransplant follow-up of 34 orthotopic heart transplant recipients.

RESULTS

Two of the 34 patients died of cardiac failure in the early postoperative period. Among the surviving patients, 10 (31.3%) developed pulmonary complications, all within the first 6 months: hospital-acquired bacterial pneumonia in five, fungal pneumonia in three, posttransplant lymphoproliferative disease in one, and community-acquired pneumonia in one patient. None of the patients developed transplantation-related malignancy. The overall mortality was 35.3%. Pneumonia-related mortality rate of 14.7% was due to early-onset nosocomial pneumonias, which were caused by bacterial and opportunistic microorganisms. Extrapulmonary causes of mortality were cardiac failure, meningitis, septicemia, and acute rejection. Cytomegalovirus antigenemia in the first month was associated with a poor prognosis. The frequency of pulmonary complications was higher among older patients and those who developed moderate rejection in the first month (P=.014 and P=.036, respectively).

CONCLUSION

Pulmonary infections after heart transplantation occurred more frequently during the first 6 months posttransplantation, accounting for a significant portion of the posttransplantation mortality.

The European Organization for Research and Treatment of Cancer QLQ-C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ-C30

The Turkish version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire version 2.0 (EORTC QLQ-C30 v.2.0) has started to be used in clinical trials recently. The objective of the study was to evaluate the validity and reliability of the Turkish version of the EORTC QLQ-C30 v.2.0 and the correlation between the Karnofsky Performance Scale (KPS) and the EORTC QLQ-C30. Two hundred and two lung cancer patients were included in the study between January and March 2000. All the subscales met the minimal standards of reliability (Cronbach's alpha > or = 0.70). Only the role functioning scale differed among the three disease stages of patients (local, locoregional and metastatic). There was no statistically significant difference among therapy types. All interscale correlations were statistically significant (P < 0.01). The strongest correlations were found among the physical functioning, role functioning and fatigue scales. Social functioning was closely related with physical, role, emotional and cognitive functioning. The weakest correlations were between nausea/vomiting and the other scales. Global quality of life (QOL) was substantially correlated with most of the scales except cognitive functioning. The coefficients for the correlation between the items differed between 0.12 and 0.97 and all the subscales were strongly correlated with the scales which they formed. The highest correlation between the EORTC QLQ-C30 and KPS was for physical functioning (r = 0.62, P < 0.05). The Turkish version of the EORTC QLQ-C30 is a valid (by means of interscales validity) and reliable instrument for Turkish lung cancer patients and can be used in clinical studies but needs supporting by the reference data on the QOL of the Turkish population.

Cord formation in MB/BacT medium is a reliable criterion for presumptive identification of Mycobacterium tuberculosis complex in laboratories with high prevalence of M. tuberculosis

We evaluated cord formation in MB/BacT broth as a rapid method for presumptive identification of the Mycobacterium tuberculosis complex. Kinyoun acid-fast-stained smears from 370 positive MB/BacT bottles were examined for the presence of serpentine cording. The smears were examined independently by two observers. Observer 1 (the supervisor of the mycobacteriology laboratory) examined all of the smears while observer 2 (a clinical microbiologist not familiar with acid-fast bacillus [AFB] microscopy) examined 148 randomly chosen smears that were read by observer 1 without knowledge of which smear was which. The sensitivity, specificity, and positive and negative predictive values of cording for the presumptive identification of M. tuberculosis read by observer 1 were 88.2, 97.4, 99.2, and 69.7%, respectively. These values were reported at 90.6, 52.3, 82.8, and 69. 7%, respectively, by observer 2. Our laboratory prevalence of M. tuberculosis among positive cultures was 78% during the time this study was conducted. At the time of positive signal of the MB/BacT bottles, the broth of the bottles had sufficient cell mass to allow for observation of the presence or absence of serpentine cording. The presence of cords in MB/BacT broth is a reliable criterion for rapid, predictive identification of the M. tuberculosis complex for laboratories with a high proportion of the M. tuberculosis complex when the smears are examined by a microbiologist who has experience with AFB staining.