Pages II - V
|5.||Infectious Diseases and Anesthesia in Children|
Duygu Kara, Feray Gürsoy
doi: 10.5222/TP.2021.52724 Pages 109 - 113
Due to vaccination and better socioeconomic conditions, childhood infectious diseases have dramatically decreased in recent years. Respiratory tract infections (RTI) are common childhood infection diseases. Although most of the upper respiratory tract infections are usually self-limited and resolve within 7-10 days, some patients have persistent symptoms for more than 3-4 weeks. Presence of both respiratory comorbidities and recent RTI can be independent predictors for adverse events during anesthesia. A RTI can increase the risk of perioperative respiratory complications from 2-7 times, hence postponement of anesthesia for elective surgeries for several weeks is applied in daily practice. The complications are most frequent during an active respiratory infection, however, bronchial hyper-reactivity can persist for 6 weeks or more even after the disappearance of clinical symptoms. In general, signs of an active lower respiratory infection, and presence of a systemic illness should warrant canceling an elective procedure. Minimum 2 weeks, up to 6 weeks of interval is advised. The potential risks of RTIs during the perioperative period lead to the cancellation of elective procedures until at least being asymptomatic. This cancellation can have important social, economic, and emotional consequences for both the child, his/her family, and the medical team. In general, signs of an active lower respiratory infection, and presence of a systemic illness should warrant canceling an elective procedure.
A consensus guideline derived from multidisciplinary points of view can provide a detailed and valid algorithm for especially challenging cases. In addition, ongoing exclusive educational and training programs could aid the clinicians in their everyday practice.
|6.||Evaluation of Success Rate of Exogenous Obesity Management with an Intensive Follow-up Program|
Gül Şeker, Eda Mengen, Fatih Gürbüz, Göksin Koçak, Yüksel Bilgin, Ali Topaloğlu
doi: 10.5222/TP.2021.14633 Pages 114 - 121
Objective: Obesity critically affects the quality and expectancy of life with its physiological, hormonal, metabolic, and social aspects. This study has assessed the success rate of exogenous obesity management consisting of lifestyle changes with an intensive follow-up in prepubertal children.
Methods: Twenty-two obese prepubertal children between ages 4 and 9 years were enrolled in this study. Eating habits were surveyed, and individually tailored diet programs were introduced. Additionally, an exercise coach prepared individualized exercise programs. Patients were recalled monthly for six months. At each monthly visit, weight, height, BMI, waist circumference, body fat percentages were measured, and compliance with the diet and exercise programs was reviewed. Wilcoxon signed-rank test was used for statistical analysis.
Results: The patients showed statistically significant reductions in BMI, waist circumference, and body fat percentage (p<0.001 for each).
Conclusion: This study demonstrates that in prepubertal obese children, lifestyle changes implemented by intensive follow-up and monitoring could increase the success rate of exogenous obesity management.
|7.||Prognostic Value of Myeloid Marker Positivity and its Association with Prognostic Factors in Pediatric Acute Lymphoblastic Leukemia|
Neval Topal, Seda Yılmaz Semerci, Muharrem Çiçek, Gönül Aydoğan
doi: 10.5222/TP.2021.36855 Pages 122 - 130
Objective: The aim of this study is to investigate the effect of myeloid marker positivity on prognosis and its relationship with classical prognostic factors in acute lymphoblastic leukemia (ALL).
Methods: Cases who were newly diagnosed with ALL, followed up in our hospital were included. CD13, CD14 and CD33 were used as myeloid markers by immunophenotyping with flow cytometry in the bone marrow samples. Any parameter higher than 20% was accepted as positive.Modified BFM-2000 protocol was used in treatment and ALL-BFM-95 residual protocols were used in relapses. Risk groups were determined according to the Trall-BFM-2000 protocol. Clinical, laboratory and demographic characteristics of participants such as age, gender, leukocyte count at the time of diagnosis, were all recorded. Patients were divided into three groups according to myeloid markers; those with negative myeloid markers (Group-I), positive one of the myeloid markers (Group-II), those with multiple positive myeloid markers (Group-III). For overall survival, death only was accepted, relapse or death were taken as failure for event free survival (EFS).
Results: A total of 96 ALL cases were included. 44 of the patients were male and 52 were female. Their ages were between 10-204 months and median value was 4.5 years. Nine patients were T-ALL (9.4%), one had biphenotype ALL (1%), and 86 had B precursor cell ALL (89.6%). Group-I had 47 patients. One or more myeloid markers were found to be positive in 49 patients (51.1%). While 42 of them consisted group-II, group-III had 7 patients. The EFS distribution for all patients was between 43,16-52 months, with a median of 45.58 months. There was no difference between the groups in terms of EFS (p 0.871).
Conclusion: This study revealed that myeloid markers had no effect on prognosis. When compared with parameters with prognostic significance, no difference was found except between FAB morphology and myeloid markers. Therefore, studies involving more patients are needed to obtain more precise information on the subject.
|8.||Prevalance of Epilepsy In School-age Children In Erzurum|
Belkıs Aygün, Hüseyin Tan
doi: 10.5222/TP.2021.76486 Pages 131 - 139
Objective: This study aimed to investigate the prevalence of epilepsy in school children in Erzurum and compare it with prevalence studies in Turkey and worldwide.
Methods: This is a cross-sectional study conducted in the center of Erzurum. From the universe formed by 74,732 students, 5,571 people were selected through the proportionate stratified sampling method and 4,560 (80%) of the 5,700 questionnaires distributed were collected. Based on the data obtained, 563 students were accepted as possible epilepsy cases and examined for epilepsy.
Results: TOf the students participating in the study, 51.3% were female and 48.6% male. Six girls (3/1000) and 10 boys (5/1000), a total of 16 cases (4/1000) were detected to be followed-up for epilepsy. Prevalence rates were found to be 4.5/1000, 2.6/1000 and 3.6/1000 for males, females and the total population, respectively. The prevalence of active epilepsy was determined to be 4/1000, 2/1000, and 3/1000 for males, females and the sum of both, respectively.
Conclusion: Epilepsy is an important health problem for our region. The prevalence of epilepsy among school-age children in Erzurum was close to the prevalence rate seen in developed countries. Febrile convulsion, low educational level and low socioeconomic level are the risk factors for epilepsy.
|9.||Herpetic Whitlow: A Case Complicated with Candidemia|
Canan Özlü, Hatice Karaoğlu Asrak, Nurşen Belet
doi: 10.5222/TP.2021.29491 Pages 140 - 143
Herpetic whitlow is a herpes simplex virus infection of fingers affecting the distal phalanx. The disease is often misdiagnosed as a bacterial infection which leads to inappropriate treatments. In this paper, we reported a case of herpetic whitlow in a 10-month-old girl who is misdiagnosed as bacterial paronychia and treated with surgical intervention and broad-spectrum antibiotics, as a result, she had invasive candidiasis which has a high mortality rate. Physicians should be aware of this entity for correct initial diagnosis and accurate management.
|10.||A Rare Location of Subgaleal Dermoid Cyst: Coronal Suture. A Propos of a Child|
Mehmet Turgut, Murat Özcan Yay
doi: 10.5222/TP.2021.64936 Pages 144 - 146
The congenital dermoid cyst (CDC) is a benign, uncommonand, slow-growing lesion that is covered with normal skin. The characteristic manifestation is at birth and the sole treatment modality is total excision. The coronal suture is a rare location for the CDCs. Herein, we report a 15-month-old female who had cranial subgaleal CDC located in the left coronal suture. The cyst was completely excised after correct radiological diagnosis with computed tomography and magnetic resonance imaging. The differential diagnosis of slow-growing lesions of the cranium and scalp should be considered.