e-ISSN: 2792-0429
Volume : 3 Issue : 2 Year : 2022
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TRENDS IN PEDIATRICS - TP: 3 (2)
Volume: 3  Issue: 2 - 2022
1.Cover

Pages I - IV

REVIEW
2.Complementary Feeding Recommendations for A Healthy Future Generation
Gizem Yonar, Ayçıl Özturan Şirin
doi: 10.4274/TP.galenos.2022.08108  Pages 30 - 37
World Health Organization data remark that 144 million children under the age of 5 are stunted by age. In Turkish society, the high weakness and stunting rates, especially among children aged 6-8 months, are an indication that complementary nutrition practices are not given enough importance in our country. Therefore, this review, it is aimed to emphasize the importance of complementary feeding in terms of the risk of malnutrition among children and to give an example of current complementary feeding practices. It is stated that at the beginning of the 5th month, infants neuromuscular development, digestive system, and renal solute load are suitable for complementary feeding. In addition to breast milk, complementary foods should include cereals, roots and tubers, legumes, nuts and seeds, dairy, meats, eggs, vegetables and fruits rich in vitamin A. Foods with allergy risk, such as eggs and peanuts should be tried for infants between 4 and 6 months. Along with breast milk, it is stated that 6-8-month olds are fed 2 or 3 times a day, and 9-11-months-old fed 3 or 4 times a day and should be paid attention to hunger and satiety signals. Complementary feeding should be started at 2 or 3 teaspoons and be increased considerably and transition should be made from pureed foods lumpy foods, finger foods and then chopped family foods until they are 12 months old. During the first year, vitamin D and iron micronutrient supplementation should be followed. It is recommended for infants to sip water instead of sugary drinks like fruit juices at meals and to introduce gluten to infants between 4 and 12 months. It is warned not to add sugar, salt and honey to the complementary feeding. To reduce the risk of malnutrition among children in Türkiye, complementary feeding should be given due significance.

ORIGINAL ARTICLE
3.The Neglected Disease of Modern Society: Trauma. Outcomes and Prognostic Factors for Pediatric Trauma Patients in PICU
Adem Dursun, Habibe Selver Durmuş, Serkan Özsoylu, Başak Nur Akyıldız
doi: 10.4274/TP.galenos.2022.14622  Pages 38 - 42
Objective: In this study it was aimed to investigate the demographic and clinical characteristics of pediatric trauma patients requiring follow-up in Pediatric Intensive Care Unit (PICU) and to contribute the data in this field by assessing the outcomes and prognostic factors.
Methods: This retrospective, observational study was carried out in the 12- bed medical PICU. We reviewed the clinical records of all trauma patients.
Results: A total of 99 patients (61 males and 38 females) were enrolled in this study. Eight patients died and the mortality rate was found as 8%. In univariate logistic regression analysis, presence of brain edema was associated to 12 folds increase in the mortality [Odds ratio (OR): 12; 95% confidence interval (CI): 2.23-64.48]. Presence of subarachnoid hemorrhage (SAH) was associated to 15 folds increase in the mortality (OR: 15; 95% CI: 2.75-81.58). Pediatric trauma score (PTS)<8 was associated to 1.17 folds increase in the mortality (OR: 1.17; 95% CI: 1.05-1.31). In the multivariate logistic regression analysis presence of brain edema was associated to 6,492 folds increase in the mortality (OR: 6,492; 95% CI: 1.078-39.06) and presence of SAH was associated to 8.68 folds increase in the mortality (OR: 8.68; 95% CI: 1.451-51.933).
Conclusion: The Glasgow coma scale score, PTS score and presence of SAH and brain edema are the factors effective on mortality in PICU.

4.The Evaluation of Local and Systemic Reactions to Subcutaneous House Dust Mite Allergen Immunotherapy
Zuhal Karalı, Şükrü Çekiç, Yağmur Hazal Şadırvan, Yakup Canıtez, Nihat Sapan
doi: 10.4274/TP.galenos.2022.46320  Pages 43 - 46
Objective: Allergen-specific immunotherapy is an effective treatment method that enables the development of immunotolerance against allergens in allergic rhinitis, asthma, and venom allergy. This study investigated the local and systemic reactions during subcutaneous house dust mite allergen immunotherapy.
Methods: Injection-related local and systemic reactions of 45 patients who received subcutaneous mite immunotherapy were evaluated retrospectively.
Results: Forty-five children, 15 (33.3%) females and 30 (66.4%) male were included in the study. A total of 582 injections were administered. A local reaction was observed in 23 (3.94%) of all injections and the systemic reaction was observed in only 1 (0.17%) injection. Sixteen (37.7%) of the children had local reactions during the immunotherapy process and 1 (2.2%) had a systemic reaction.
Conclusion: Although subcutaneous mite immunotherapy is a safe treatment, it should only be applied in centers with appropriate emergency equipment and trained healthcare professionals due to possible systemic reactions.

5.Therapeutic Plasma Exchange for Treating Pediatric Neurological Diseases
Gürkan Atay, Hatice Yazar, Seher Erdoğan, Hazal Ceren Tuğrul, Hüsniye İşcan, Büşra Kutlubay
doi: 10.4274/TP.galenos.2022.83997  Pages 47 - 50
Objective: Therapeutic plasma exchange (TPE) is performed in various neurological, hematological, renal and autoimmune diseases. This study was conducted to determine the indications, efficacy, safety and complications of TPE in pediatric autoimmune neurological diseases.
Methods: In this study, patients who were hospitalized in the pediatric intensive care unit of a tertiary university hospital between January 2017 and December 2021 and underwent TPE due to neurological diseases were evaluated retrospectively.
Results: A total of 20 patients were included in the study. Their ages ranged from 6 to 237 months, with a mean age of 63.16±183.12 months. Neurological TPE indications of the patients were autoimmune encephalitis (50%, n=10), Guillain-Barre Syndrome (45%, n=9) and Acute Demyelinating Encephalomyelitis (6.7%, n=1), respectively. Catheter occlusion was observed in 2 (10%) patients, allergic reaction in 1 (5%) patient, and hypotension in 1 (5%) patient as complications of TPE. Muscle strength of patients with GBS was evaluated according to the Medical Research Council scale before transfer to the service. It was determined that the score increased from 0 to 1 in two patients, from 0 to 3 in three patients, and from 1 to 5 in four patients. In 9 of the patients diagnosed with encephalitis, regression of acute phase reactants and improvement in neurological evaluation were observed.
Conclusion: When TPE is applied with appropriate indications and by an experienced team in pediatric neurological diseases, treatment results can are satisfactory, its effectiveness increases and the complication rate decreases.

CASE REPORT
6.Angioedema Related to Infectious Mononucleosis
Duygu Lüleci Dağlı, Hasan Yüksel, Seda Tunca, Özge Yılmaz
doi: 10.4274/TP.galenos.2022.74745  Pages 51 - 53
Epstein-Barr virus (EBV), a member of the Herpes-viridae family, is a microorganism could be present in various clinical presentations, from upper respiratory tract infection findings to asymptomatic liver function test elevation, from facial paralysis to angioedema. This case report has been prepared to emphasize EBV infection as a rare factor in the etiology of angioedema.

7.Lercanidipine Intoxication in A 16-Year-Old Adolescent
Volkan Bayar
doi: 10.4274/TP.galenos.2022.29484  Pages 54 - 57
Lercanidipine is a 1,4-dihydropyridine calcium channel blocker. For severe toxicity, treatment modalities are based on a restricted range of evidence and clinical experience. This case report describes our clinical experience regarding the treatment of Lercanidipine overdose in a 16-year-old girl. To the best of our knowledge, this is the first reported pediatric case overdose of lercanidipine.

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