ISSN: 2718-0085
Volume : 1 Issue : 2 Year : 2020
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TRENDS IN PEDIATRICS - TIP: 1 (2)
Volume: 1  Issue: 2 - 2020
1.Cover

Page I

2.Advisory Board

Pages II - IV

3.Contents

Page V

4.Editorial

Page VI

ORIGINAL ARTICLE
5.The Effect of Obesity on Asthma: Lung Function Analysis Using the Impulse Oscillometry in School-age Children
Zeynep Güleç, Pınar Uysal
doi: 10.5222/TP.2020.70288  Pages 31 - 38
INTRODUCTION: Studies investigating the lung function of school-age obese asthmatics are rare. The purpose of this study was to compare lung functions in school-age obese asthmatics with non-obese asthmatics.
METHODS: Ninety-two children were assigned to obese asthmatics (OA group, n=43) and non-obese asthmatics (A group, n=49) groups. A baseline impulse oscillometry test was performed to measure lung functions.
RESULTS: Baseline percent predicted value of R20 (p=0.025), R5-20 (p=0.040), and Fres (p=0.018) were significantly increased in obese asthmatics than non-obese asthmatics. AX was also higher in obese asthmatics compared to non-obese asthmatics, however, the difference was insignificant (p=0.787). Percent predicted value of R5 (p=0.007) and R10 (p=0.017) were higher in atopic than non-atopic obese asthmatics. Percent predicted value of R5 was higher in exercise-intolerant than exercise-tolerant non-obese asthmatics (p=0.045). Additionally, R10 was higher in non-obese asthmatics with household mold exposure than that without household mold exposure (p=0.045). The z scores of BMI or weight were correlated with none of the IOS parameters (p>0.05).
DISCUSSION AND CONCLUSION: Main bronchial and peripheral airway resistance were higher in school-age obese asthmatics compared to non-obese asthmatics. Peripheral airway resistance was higher in atopic obese asthmatics as well as in exercise intolerant asthmatic children and those with household mold exposure.

6.Childhood Pilomatrixoma: Case Series from a Single Center
Begümhan Demir Gündoğan, Fatih Sagcan, Mehmet Alakaya, Ferah Tuncel Daloglu, Elvan Çağlar Çıtak
doi: 10.5222/TP.2020.43534  Pages 39 - 43
INTRODUCTION:
The aim of this study is to describe our institutional experience with pilomatrixoma in children, specifically examining its clinical presentation, associated conditions, radiological and pathological findings and attract attention to differential diagnosis for this tumor.
METHODS: The medical records of 52 patients were reviewed retrospectively.


RESULTS: There were a total of 62 tumors in 52 children. The median age at excision was 9.5 years old. Tumors were predominantly located in head and neck region (48.4%). One patient had a family history of pilomatrixoma. One patient had Turner Syndrome and one had Tuberous Sclerosis complex. Fifty-four lesions were examined by ultrasonography (USG). Pilomatrixoma was considered in the differential diagnosis in eight patients (15.3%) by a radiologist.
DISCUSSION AND CONCLUSION: Pilomatrixoma is one of the most common causes of superficial masses in children. It should be kept in mind for differential diagnosis in children with superficial masses.

7.Comparison of Complete Blood Count Parameters in Children with Kawasaki Disease and Viral Febrile Infections
Serkan Fazlı Çelik, Soner Sertan Kara, Elif Çelik, Şükrü Güngör
doi: 10.5222/TP.2020.09797  Pages 44 - 48
INTRODUCTION: Kawasaki disease (KD) is a childhood vasculitis, and the inflammation of coronary arteries is the most severe complication of KD. Despite the fever, diagnosis may be delayed when clinical symptoms do not fulfill the criteria. In this study, we aimed to determine whether the complete blood count (CBC) parameters can differentiate KD from other diseases that caused fever in children.


METHODS: The present study included 51 patients, 21 of whom were diagnosed as KD and 30 febrile non-KD patients who had viral or infections. We analyzed groups' initial CBC parameters in the first visit.
RESULTS: Fourteen of the 21 patients (66%) were atypical KD. There were no statistically significant differences in patients' characteristics, clinical symptoms, and signs between the groups. Six of the patients had abnormal coronary arteries like dilatation. A higher neutrophil-to-lymphocyte ratio (NLR) (2.5 (1.8–5.9) vs. 1.41 (0.89–3.6); p=0.028, retrospectively) and higher CRP levels (58.1 (25.6–129.3) vs. 22.8 (4.3–41.6); p= 0.021, retrospectively) were found in KD group when compared with non- KD group. When combining NLR> 1.41 and CRP> 31 mg/L, there was a higher odds ratio of 24.84 (95% confident interval (2.41–198.53) of KD predicting the possibility.
DISCUSSION AND CONCLUSION: Neutrophil-to-lymphocyte ratio and CRP can show inflammation and immune reactivity, and they can be used to distinguish KD patients from virally infected children.

8.Impaired Lung Functions Using Tidal Breath Analysis in High-risk Infants with Recurrent Wheezing
Ayşe Anık, Pinar Uysal
doi: 10.5222/TP.2020.43153  Pages 49 - 54
INTRODUCTION: We aimed to investigate lung functions using tidal breath analysis (TBA) in high-risk infants with recurrent wheezing.
METHODS: Lung functions measured using TBA in infants with physician-diagnosed recurrent wheezing (≥3 episodes) who applied our institution between 2018-2020, were retrospectively analyzed. Infants were assigned to two groups: high-risk infants with recurrent wheezing (n=30) and wheezy infants without high risk of atopy (n=33).
RESULTS: High-risk infants with recurrent wheezing had lower mean values of tPTEF, tPTEF: tE, VPTEF, and VPTEF: VE than that of wheezy infants without high risk of atopy. There was no significant difference between two groups in terms of Vt/kg and respiratory rate. ROC curve analysis showed that tPTEF: tE ratio <26.5 demonstrated 63.3% sensitivity and 63.6% specificity for detection of high risk of atopy.
DISCUSSION AND CONCLUSION: This study showed that high-risk infants with recurrent wheezing have lower lung function than those of wheezy infants without high risk of atopy. TBA might be useful method to evaluate lung function in wheezy infants.

9.Testicular Adrenal Rest Tumors in Patients with Congenital Adrenal Hyperplasia: A Case Series
Didem Yildirimçakar, Selda Ayça Altincik, Murat Öcal, Bayram Özhan
doi: 10.5222/TP.2020.87587  Pages 55 - 60
INTRODUCTION: Testicular adrenal rest tumors (TARTs) are the main etiology of infertility in congenital adrenal hyperplasia (CAH). The aim of this study is to determine the patients diagnosed with TART and to evaluate the risk factors associated with the development of the disease.
METHODS: Clinical characteristics of 31 patients with CAH including 19 male, and 12 female patients who were followed up in our clinic were retrospectively reviewed regarding the presence of TART. Differences between clinical and laboratory findings of patients with and without TART were examined. Six male patients with TART were included in the study. Clinical characteristics such as pubertal stage, treatment doses, laboratory findings were evaluated. Changes in size of TARTs were examined with ultrasound follow-ups at six month- intervals.
RESULTS: The prevalence of TARTs was 31.5 % (6/19 male). Precocious puberty was higher in patients with TART than without TART. The mean age of the patients was 9.1±2.4 (range: 5.2-12.4) years at the time of diagnosis with TART. Five patients with TART were inadequately controlled. Four patients had a history of precocious puberty. Tumor progression was detected in 4 of 6 patients. In three patients with tumor progression, serum 17-hydroxy progesterone (17-OHP) values increased during follow-up, probably due to non-compliance with treatment.
DISCUSSION AND CONCLUSION: Scrotal ultrasound monitoring should be performed in all male patients with CAH in early childhood irrespective of disease control.

10.The Knowledge and Attitudes of Medical Students, Nurse Trainees, and Pediatric Patients’ Caregivers About Influenza and Influenza Vaccination in Prepandemic Era
Soner Sertan Kara, Seher Bacak, Alper Aslan, Şükrü Güngör
doi: 10.5222/TP.2020.79188  Pages 61 - 67
INTRODUCTION: Influenza is a highly contagious respiratory infection influencing all aged people. Healthcare workers (HCWs) not only are vulnerable to influenza infection, but also act as a possible mediator for infection transmission. The best way to prevent influenza is annual vaccination. The aim of this study is to evaluate the knowledge and attitudes of medical students, nurse trainees, and pediatric patients’ caregivers about influenza and influenza vaccination in our tertiary hospital.
METHODS: We performed the study between April 01, 2019 and June 01, 2019. The survey consisted of a 22-item questionnaire that included questions about the demographic properties, vaccination status, decisions and attitudes about the influenza disease and influenza vaccination.
RESULTS: Among 600 participants 502 of them completed the survey (response rate: 83%). One hundred and fifty participants from each group, who fully completed the questionnaires were included in the study. Most of the study participants have never get flu vaccination before (p<0.001). It was seen that the difference between common cold and flu was better known by medical students and nurse trainees, than the caregivers (p<0.001). A higher percentage of caregivers agreed with the decision that flu could not disappear without using antibiotics (26.0% vs 5.3% and 6.7%) (p<0.001). Most of the participants declared the thought of unnecessity of vaccination, as influenza is a simple infection (p=0.05). Approximately half of the medical students, 70% of the nurse trainees, versus 46% of the caregivers reported that to experience a disease itself is better than vaccination against it (p=0.007). A higher proportion of caregivers noted that they heard or read about harmful effects of influenza vaccines on internet or social media (p=0.008).
DISCUSSION AND CONCLUSION: This study showed that most of the study participants did never get flu vaccination before. The difference between common cold and flu was better known by medical students and nurse trainees. A higher ratio of caregivers agreed that flu could not disappear without using antibiotics. Most of the participants declared the thought of unnecessity of vaccination. High percentage of participants had misinformation regarding influenza vaccines. A higher proportion of caregivers noted that they heard or read about harmful effects of influenza vaccines on internet or social media.

11.Comparison Between Celiac Patients and Healthy Control Group Regarding Vitamin-Mineral Levels and Complete Blood Count Parameters
Şükrü Güngör, Can Acıpayam
doi: 10.5222/TP.2020.87597  Pages 68 - 74
INTRODUCTION: We aimed to compare the mean platelet volume (MPV) and plateletcrit (PCT) and vitamin-mineral levels in pediatric celiac disease patients with the healthy control group and to compare the results with the literature.
METHODS: In this study, clinical and laboratory data of 80 pediatric patients diagnosed with celiac disease (CD) between July 2017 and December 2018 and 42 healthy children in the same age group were retrospectively analyzed.
RESULTS: There was no significant difference between the groups in terms of age and gender (p=0.383, and p=0.462, respectively). The frequency of anemia, folate, iron and vitamin D deficiencies was higher in celiac patients compared to the control group (p=0.001, p=0.027, p<0.001, and p<0.001, respectively). When the patients were evaluated according to their complete blood count and vitamin-mineral levels; hemoglobin (Hb), mean corpuscular volume (MCV), ferritin and vitamin D levels were found to be significantly lower in the CD group compared to the control group (p<0.001, p=0.026, p<0.00, and p=0.001, respectively). Platelet (PLT), PCT, MPV levels were found to be significantly higher in the CD group compared to the control group (p=0.010, p<0.001, and p<0.001, respectively). We found a weakly negative correlation between the vitamin D levels and the degree of the Marsh classification (r: -0.273, and p=0.023).
DISCUSSION AND CONCLUSION: Our study have shown that MPV, PCT values are higher and Hb, folate, iron and vitamin D levels are lower in patients with CD compared to healthy controls. We recommend investigating other nutrient deficiencies besides iron deficiency, especially in treatment-resistant anemias. We think that the correlation between vitamin D levels and the degree of histological damage should be elucidated with larger-scale and more comprehensive studies.

12.An Evaluation of Pediatric Intensive Care Unit Infection Rates and Various Risk Factors
Ayşe Ulus, Soner Sertan Kara, Elif Çelik
doi: 10.5222/TP.2020.66376  Pages 75 - 80
INTRODUCTION: The pediatric intensive care unit (PICU) is a unit in which the general condition and vital signs of patients aged one month to 18 years are continuously monitored, and support treatments after advanced pediatric and surgical procedures are provided. Healthcare-associated infections (HAIs) can develop during some interventions and treatments. The purpose of this study was to investigate infection and handwashing rates for the previous five years in a hospital PICU providing tertiary intensive care and to examine HAI agent microorganisms and their resistance rates.
METHODS: Data for patients followed-up at the Aydın Adnan Menderes University Hospital PICU between 1 January 2015, and 30 October 2020, were examined retrospectively. The study data were obtained from the hospital microbiology laboratory culture specimen results, radiology data, clinical visits, and information recorded on the National Healthcare-Associated Infections Surveillance System. HAIs rates, density, infectious agents and resistance rates, and hand hygiene compliance rates were calculated from these data.
RESULTS: Two hundred and thirty-three patients were included in the study. The mean annual number of patient days was 1742±322. The mean annual total number of infections was 9.0±3.9, the mean infection rate was 4.2±2.8, and the mean infection density was 5.0±1.5. Bloodstream infections constituted the most common infections, followed by ventilator-associated pneumonia (VAP). Carbapenem resistance at a rate of 50% was determined for both Acinetobacter spp. and Pseudomonas aeruginosa. A strong correlation was determined between VAP and patient days (p=0.05, r=0.80). Hand hygiene observations revealed compliance rates of 48.1±14.3 in nurses, 33.9±28.2 in patient carers, 31.8±12.5 in physicians, and 30.9±26.2 in cleaning personnel
DISCUSSION AND CONCLUSION: Mean annual infection numbers in this study were similar to those of previous studies from other centers. The most common infection was bloodstream infections. Nurses had the highest handwashing rates, with physicians in the third place. Higher VAP was correlated with increased patient days.

LETTER TO THE EDITOR
13.Children of Africa as silent victims of COVID-19 Pandemics
Francisco Jose Lopes Junior
doi: 10.5222/TP.2020.80299  Pages 81 - 83
Abstract | Full Text PDF

14.Subject Index - Author Index

Page E1
Abstract | Full Text PDF

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