The Journal of Pediatric Academy
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Published By Medihealth Academy

2718-0875

2021 ◽  
pp. 111-116
Author(s):  
Murat Doğan ◽  
Binnaz Çelik

The Coronavirus disease (COVID-19) rapidly spread all around the world and was declared a worldwide pandemic by World Health Organization in March 2020. We aimed to investigate the clinical, demographic and laboratory characteristics of COVID-19 in children admitted to the pediatric emergency triage. Epidemiological, clinical, laboratory, and radiological data of children were collected retrospectively and analyzed to compare by symptoms. A total of 213 pediatric cases with COVID-19 were included. Most of the patients were asymptomatic (63.8%). The main clinical features were mild symptoms including fever (7.5%), cough (6.5%), myalgia (6.3%) or no (63.8%). Of the patients who had CT scan, 25% had specific findings of COVID-19. Ground-like opacities were common radiological findings (25%). Symptomatic patients had higher lymphopenia rate (p=0.03), higher CRP and procalcitonin (PCT) values (p=0.04, p=0.04), lower age (p<0.001) and lower neutrophil count (p=0.01). The rate of neutropenia and leukopenia were higher in asymptomatic patients (p=0.15, p=0.05, respectively). The most common cause of transmission in children is family contact. Home isolation was recommended for 89.6% of the patients, 10.3% were hospitalized, 2.3% needed an intensive care unit (ICU). Only one death was reported. We found found that children with COVID-19 are generally mild severe or asymptomatic clinic. Young children were relatively more symptomatic than older children, and those with underlying diseases often needed intensive care unit. The most important laboratory findings difference between symptomatic and asymptomatic patients are lymphopenia, increased CRP and PCT values (p=0.04 for all three parameter).


2021 ◽  
pp. 82-90
Author(s):  
Aslı İmran Yılmaz ◽  
Sevgi Pekcan

Childhood bronchiolitis obliterans (BO) is an uncommon complication that is characterized clinically by persistent and continuous obstructive respiratory symptoms, and has been described secondary to various etiologic factors, including drugs, exposure to toxic fumes, allergic reactions, collagen vascular disease or infections. BO occurs most commonly in children after an episode of acute bronchiolitis and is considered a long-term sequela of viral infection.Postinfectious Bronchiolitis Obliterans (PIBO) is characterized by persistent airway obstruction with functional and radiological evidence of small airway involvement that is in general unresponsive to bronchodilator treatment.Although the condition is relatively rare, and its exact incidence is unknown, it is important to keep it in mind. PIBO is complication of lower respiratory tract epithelial injury, and is often misdiagnosed, delaying recognition and potential treatment. A PIBO diagnosis is usually based on a few factors, including a good medical history, positive clinical findings, and lung function test and imaging results, although biopsy and histopathology remain as the optimum diagnostic approach. There have to date been few studies proposing treatments for the condition, and no accepted protocol exists in literature. There is usually a fixed airway obstruction in PIBO. Various treatment approaches have been extrapolated from studies of post bone marrow transplantations and lung transplant BO. The clinical course is variable, and good supportive therapy is essential, with anti-inflammatory therapy often being employed.


2021 ◽  
pp. 91-96
Author(s):  
Ülkü Gül Siraz ◽  
Nihal Hatipoğlu

In childhood and adolescence cancers; survival rates increase with the use of treatment options such as chemotherapy, radiotherapy and hematopoietic stem cell transplantation. One of the long-term effects of primary disease and cancer treatment is the irreversible damage to gonadal tissues, resulting in impaired fertility. Especially chemotherapeutic drugs; causes germ cell defect, affects the secretion of pituitary hormone, and also damages the anatomical structures of internal genital structures such as the uterus. Gonadal preservation methods are limited in prepubertal male patients. It is a good option to place the testicles in a different area before radiotherapy. Before chemotherapy or whole body irradiation, freezing of testicular tissue and ensuring pregnancy from frozen tissue is still in the experimental stage. After the ejaculation begins, obtaining and storing sperm is successfully done. A limited number of pregnancies were obtained oocytes frozen ovaries in the prepubertal girls. It is possible to freeze oocytes after puberty begins. In addition, recently, as a noninvasive method, gonadotropin-releasing hormone (GnRH) analogues have been used successfully, as it suppresses the hypothalamic-pituitary-gonadal axis and protects germ cells from cytotoxic effects. This article aims to provide information on fertility preservation methods in patients receiving childhood cancer treatment.


2021 ◽  
pp. 106-110
Author(s):  
Neslihan Günay ◽  
Sevda İsmailoğluları ◽  
Esra Özdemir Demirci ◽  
Fatih Kardaş ◽  
Hüseyin Per

Restless Legs Syndrome (RLS), which may be a missed diagnosis in children, is seen at an important frequency. The aim of this study was to investigate the clinical characteristics of patients with RLS and to show the effect of RLS on school success. Forty-three patients with RLS and 43 healthy volunteers were included to the study. Blood samples were taken to measure ferritin. The averages of school exam scores were recorded. The patient group was classified as mild, moderate, severe, and very severe according to the RLS rating scale. The daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS). The"Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S)" was completed by parents, and patients' inattention, and hyperactivity-impulsivity scores were compared with the control group. According to the RLS rating scale scores 25.6% (n:11) were evaluated as mild, 60.5% (n:26) were moderate and 14% (n:6) were severe. The mean ferritin level was significantly lower in the patient group. The mean score of inattention and hyperactivity-impulsivity in the patient group to be significantly higher than the control. The mathematics and science course mean grades were significantly lower in the patient group than the controls (66.7±17.7 vs 74.2±11.7). ESS scores were found to be significantly higher in the patient group. In this study, RLS has been found associated with ADHD and iron deficiency, similar to previous studies. There are not many studies on the effects of RLS in children on daily life and this study has objectively shown that RLS reduces patients' school achievement


2021 ◽  
pp. 121-123
Author(s):  
Müge Atar ◽  
Özgür Pirgon ◽  
Gülsüm Çetin

Increasing incidence and onset at a younger age has changed the treatment strategy of diabetes mellitus (DM) towards prevention, delaying the onset, and minimizing disease complications. Self-monitoring blood glucose systems and continuous glucose monitoring systems are routinely preferred in diabetic children.Flash glucose monitoring system has come as an entirely new concept in glucose monitoring by providing much greater data than blood glucose testing while being more affordable than the continuous glucose monitors. The FreeStyle Libre provides ‘flash glucose monitoring’ with glucose readings by scanning a sensor rather than pricking the patient’s finger. The sensor measures interstitial tissue glucose levels every minute via a disposable round sensor with a small catheter inserted under the skin that can be worn for up to 14 days. The entire system’s on-body sensor patch worn on the back of the upper arm is disposable. However, the mild erythema may occur on the skin and disappear spontaneously after 24 hours from the detachment of the sensor. Similar skin lesions were observed in diabetic patients, and there was moderate to severe itching in 0.5% of the cases and moderate erythema in 4% of cases


2021 ◽  
pp. 97-100
Author(s):  
Hülya Nalçacıoğlu ◽  
Demet Tekcan ◽  
Hülya Gözde Önal ◽  
Özlem Aydoğ

Congenital nephrotic syndrome (CNS) is characterized by severe proteinuria, hypoalbuminemia, and edema within the first three months of life. Congenital nephrotic syndrome can occur due to perinatal infections or mutation of genes encoding structural or regulatory proteins of the glomerular filtration barrier. Treatment includes albumin infusions, nephrectomy, dialysis, and transplantation. In this study, we aimed to evaluate the demographic, clinical, and follow-up results of patients with CNS followed up in our center between 2010 and 2020. Demographic, clinical, laboratory values of 8 patients diagnosed with CNS between 2010 and 2020, kidney biopsy results, genetic examinations, and follow-up results were retrospectively evaluated. A total of 8 patients (4 girls) were included in this study. The median age at diagnosis was 36 days (3 days-8 months) and the follow-up period was 34 months (7-114 months). There was a history of prematurity and consanguinity in 5 patients. Edema was detected at the admission of all patients. Albumin infusion and captopril therapy were started from the diagnosis. No pathology was seen in the tests for perinatal infection, and ultrasonographic examinations were normal. In the genetic analysis, NPHS1 (Nephrin) homozygous mutation was detected in six patients, and coenzyme Q2 mutation was detected in one patient. Peritoneal dialysis treatment was performed in four patients during the follow-up, and unilateral nephrectomy was completed in one patient. During the follow-up, four of eight patients (three due to sepsis while on dialysis, one on the postoperative after the first day of transplantation) died. Three patients are followed up with kidney transplantation and one with supportive treatment. According to our results, most CNS cases are genetic, and nephrin mutation is the most common cause. Management of complications in CNS is crucial for patient surviva


2021 ◽  
pp. 117-120
Author(s):  
Ahmet Sami Güven ◽  
Mehmet Burhan Oflaz ◽  
Ali Kaya ◽  
Fatih Bolat ◽  
Utku Aygüneş ◽  
...  

Sydenham’s chorea (SC) is common cause of acquired chorea in childhood. SC occurs mainly in children with untreated streptococcal infections. An effective list of therapeutic options has been used to treat this disorder: antiepileptic drugs (valproic acid, carbamazepine etc.), haloperidol, chlorpromazine, amphetamines, steroids, plasma exchange and intravenous immunoglobulins (IVIG). We report a 12-year-old girl with carditis and severely generalized chorea and successfully treated with IVIG. This case report shows that IVIG is an effective treatment for the chorea cases resistant to anticonvulsants, dopamine antagonists and steroids, although larger studies are needed to confirm this conclusion.


2021 ◽  
pp. 101-105
Author(s):  
Esra Bağlan ◽  
Semanur Özdel ◽  
Tülin Güngör ◽  
Deniz Karakaya ◽  
Evra Çelikkaya ◽  
...  

Behçet’s disease (BD) is a multisystemic inflammatory disease with unknown etiology. It is characterized by recurrent oral and genital ulcerations, uveitis, and skin lesions, various musculoskeletal, gastrointestinal, central nervous system, and vascular manifestations. The aim of this study was to analyse the demographic characteristics and clinical features, treatment in Turkish paediatric BD from a single center experience. The records of 36 patients with BD who were diagnosed according to the International Study Group criteria between January 2017 and January 2019 in the department of paediatric rheumatology, were retrospectively reviewed. Data on demographic, clinical features and therapy were collected. A total of 36 (19 male) patients were included in this study. Mean age at disease onset was 9.36±4.45 years and mean age at diagnosis 13.99±2.83 years. The frequencies of signs/symptoms were: recurrent oral aphtosis 100%, genital ulcers 80.6%, musculoskeletal 30.6%, ocular 16.7%, neurological 11.1% and vascular involvement 11.1%, gastrointestinal 2.8%. Colchicine and corticosteroids were the main treatments. In this single-center retrospective study, we analyzed the data of paediatric BD and their treatment from a single center in Turkey. The presented small series and the literature review suggest that paediatric BD is a heterogeneous disease with varied clinical manifestations.


2021 ◽  
pp. 74-76
Author(s):  
Esra Türe ◽  
Abdullah Yazar ◽  
Fatih Akın ◽  
Ahmet Osman Kılıç

A complete or partial involuntary erection that occurs in absence of a sexual stimulation and lasts longer than four hours is defined as priapism. Etiology usually includes sickle cell disease or hematologic malignancies. Less common causes include trauma, spinal cord injury, medications, congenital syphilis, parotitis, Fabry’s disease and retroperitoneal sarcoma. Priapism is a urologic emergency that varies by ischemic and non-ischemic episodes. Ischemic injury to cavernous tissues leads to erectile dysfunction. Early recognition of priapism, determination of the type and the treatment are crucial in preventing potential long-term complications caused by priapism. With this case of priapism caused by a treatment with valproic acid, it was aimed to point out priapism which is a urologic emergency.


2021 ◽  
pp. 77-79
Author(s):  
Selim Kurtoğlu ◽  
Mustafa Armut ◽  
Figen Öztürk

There are different causes of urogenital bleeding in prepubertal girls. These include vulvovaginitis, urinary infections, urethral prolapse, urethral caruncle, vaginal foreign bodies, hormonal causes, tumors, posterior labial fusion, lichen sclerosis. Among the tumors, rhabdomyosarcoma and papilloma are prominent. In this article, a case of urogenital hemorrhage due to papilloma located at the base of the bladder was presented and the relevant literature was reviewed


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