The Turkish journal of pediatrics最新文献

Background: Children diagnosed with preseptal cellulitis frequently require hospitalization, leading to both clinical management challenges and substantial healthcare-related costs. The condition often necessitates intravenous antibiotic therapy, radiological imaging, laboratory tests, consultations, and inpatient care, which collectively contribute to the overall economic burden. However, data on the clinical characteristics and cost distribution among pediatric patients remain limited. This study aimed to evaluate both the clinical and economic burden of preseptal cellulitis in hospitalized children and to identify the clinical factors influencing healthcare costs.

Methods: This retrospective study included children aged 1 month to 18 years who were hospitalized with a diagnosis of preseptal cellulitis between January 2019 and December 2024. Patients were grouped according to age and presence of predisposing factors. Length of stay, total hospital costs, and cost components were analyzed based on clinical characteristics.

Results: A total of 166 patients were included (mean age: 70.1 ± 46.9 months; 62% male). The most common findings were periorbital swelling (96.4%) and erythema (75.3%). Median length of stay was 5 days, with no significant differences by age, sex, or predisposing factors (p>0.05). However, a strong positive correlation was found between length of stay and total cost (rho=0.775, p.

Background: Adenovirus infections are commonly associated with respiratory tract infections, conjunctivitis, gastrointestinal disturbances, and in some cases, more severe illnesses such as pneumonia. Guillain-Barré syndrome (GBS), a rare autoimmune disorder that causes progressive peripheral nerve inflammation and paralysis, has been linked to various infections, including viral ones.

Case presentation: We describe two newly diagnosed pediatric cases of GBS following adenovirus infection. Both patients were previously healthy boys, aged 3 and 6 years. Adenovirus was detected by nasopharyngeal PCR shortly preceding the neurological manifestations. Both were treated with intravenous immunoglobulin (IVIG); one also required plasma exchange and respiratory support. Both recovered fully during follow-up. Additionally, a relevant case from the literature was reviewed for comparison. Treatment included respiratory support, IVIG and plasma exchange therapy. During the 12-month follow-up no severe complications were observed in our patients.

Conclusions: In conclusion, while GBS is a well-established complication of several viral infections, including adenovirus, the association between adenovirus and GBS remains relatively underexplored. Our case reports, along with a review of the literature, highlight the rare but plausible link between adenovirus infection and the development of GBS. Although adenovirus infections are common, the occurrence of GBS following these infections appears to be uncommon, suggesting that additional factors may be at play. However, given the potential severity of GBS and the growing body of evidence, it is important for clinicians to remain vigilant for this rare complication in patients with a history of adenovirus infection.

Background: Influenza remains a primary global health concern associated with significant morbidity and mortality, especially among high-risk pediatric populations. Pediatric residents are involved in the diagnosis, treatment, and prevention of influenza during their training; however, gaps in influenza-related knowledge have been reported. The aim of this study was to evaluate the impact of a structured educational seminar on improving pediatric residents' knowledge of influenza symptoms, complications, treatment, and vaccination practices.

Methods: This prospective, single-center, pre-post study included pediatric residents at a tertiary hospital. Participants completed the same structured 25-item questionnaire immediately before and one month after a 60-minute educational seminar on influenza. The questionnaire assessed knowledge of clinical symptoms, transmission routes, antiviral treatment, chemoprophylaxis, and vaccination. Item-level correct response rates and the total knowledge score (range 0-25) were compared between pre- and post-seminar assessments.

Results: Sixty-two residents participated. After the seminar, correct response rates increased for several clinical features, including sudden onset of illness (p = 0.006), rapid progressive disease (p = 0.003), diarrhea (p < 0.001), abdominal pain (p < 0.001), febrile seizure (p = 0.003), and complex febrile seizure (p < 0.001). Knowledge regarding transmission routes and oseltamivir-related adverse effects improved significantly (p < 0.05), while chemoprophylaxis-related items showed mixed changes in correct response rates. The total knowledge score increased from 14 (interquartile range [IQR]: 12-16.25) to 18 (IQR: 15-21) after the seminar (p < 0.001).

Conclusion: A single, structured educational seminar was associated with improvements in several domains of influenza-related knowledge among pediatric residents. The observed declines in selected chemoprophylaxis items indicate that some topics may require repeated or reinforced educational approaches.

Background: Early feeding skills and general movements (GMs) are negatively affected by hypotonia due to prematurity. Interventions for feeding skills can be guided by understanding the relationship between feeding skills and GMs. In the light of this, the study focused on understanding the relationship between early feeding skills and preterm infants' GMs in the neonatal intensive care unit (NICU).

Methods: Participants in this cross-sectional study were forty infants with a postmenstrual age of 34-37 weeks who were hospitalized in the NICU at Abant İzzet Baysal University Training and Research Hospital. The data consisted of demographic characteristics (birth weight, gestational age, date of birth, age, and sex), feeding skills, assessed with the Early Feeding Skills Assessment Tool, and GMs, assessed with the General Movement Assessment.

Results: A strong correlation was found between the Oral-Motor Function subscale of the Early Feeding Skills Assessment Tool and the Upper Limbs subscale of the General Movements Motor Optimality Score (rho=0.74, p=0.001). Among the demographic characteristics, only maternal age was associated with feeding skills. A weak correlation was determined between the Physiologic Stability subscale of the Early Feeding Skills Assessment Tool and maternal age (rho=0.34 p=0.03).

Conclusions: This study reveals the relationship between feeding skills and general movement of preterm infants at NICU. GMs of upper extremity were found to positively affect feeding skills. This process may be accelerated by interventions to improve the GMs of upper extremity during the transition to oral feeding.

Background: Biotinidase deficiency is a core condition in newborn screening programs worldwide. While fluorometric enzyme activity assays from dried blood spots (DBS) are the standard first-tier test, their accuracy can be susceptible to pre-analytical variation. To date, the specific impact of hematocrit (HCT), punch location, and cellular interference on fluorometric biotinidase measurements have not been systematically examined.

Methods: We prepared blood pools to isolate specific variables: a reference pool at 50% HCT (HCT50), a low-HCT pool at 34% (HCT34), and a leukocyte-depleted pool (HCT50(-W)). Secondary pools were created with biotinidase activities of 0, 50, 100, and 200 U. DBS samples were prepared from all pools. Biotinidase activity was measured fluorometrically from central and peripheral punches (n=12 per condition). Statistical analysis included t-tests and Cohen's d effect sizes, with a >10% deviation set as the threshold for clinical significance.

Results: Our results demonstrated a significant systematic bias: Peripheral punches yielded higher biotinidase activity than central punches across all sample types (13.36%-16.61% difference, p20% higher values at the critical biotinidase activity-50 U level. Crucially, leukocyte depletion resulted in a statistically significant decrease in measured activity (~10.6%, p.

Background: Scientific congresses are critical platforms for knowledge dissemination and collaboration. The scientific value of presented abstracts is best demonstrated through their subsequent publication as full-text articles in peer-reviewed journals. This study aimed to evaluate the publication rate and characteristics of oral abstracts presented at the Turkish National Pediatric Congresses (TNPC) between 2019 and 2023.

Methods: Abstract books of five consecutive congresses were reviewed. The publication status of each abstract was determined through systematic searches in Web of Science, PubMed, Scopus, Google Scholar and the TR Index utilizing the title, keywords from the title and author names. Parameters such as study design, collaboration type, index status and the impact factor of the journal, the year it was published, and time to publication were analyzed. Additionally, the subspecialty of each abstract and the publication rate for each subspecialty were evaluated.

Results: Among 268 oral abstracts, 111 (41.8%) were published as full-text articles. Of these, 66 (59.5%) were published in journals indexed in the Science Citation Index Expanded. Approximately one-third (32.4%) of the articles were published in Q1 or Q2 ranked journals. The average impact factor was 1.72 ± 1.26 and the mean time to publication was 1.6 ± 1.17 years. The most common study design published was retrospective (51.3%), and the majority were single-center studies (88.3%). The highest publication rates were observed in the fields of rheumatology, adolescent medicine, and infectious diseases.

Conclusion: A significant portion of the papers presented at TNPC congresses are published in peer-reviewed scientific journals. The fact that more than one-third of the published studies appear in high-impact journals demonstrates the academic quality of the papers presented at the congresses and the effectiveness of the selective evaluation process. The findings provide valuable contributions to the monitoring and development of academic productivity in the field of pediatrics in Türkiye.

Background: Actinomycotic osteomyelitis is a rare, chronic infection caused by Actinomyces species, anaerobic bacteria normally found in the oral flora. Mandibular involvement is uncommon and may mimic malignancies, complicating diagnosis.

Case presentation: A 15-year-old previously healthy male presented with painful neck swelling and trismus. Examination revealed a firm mass at the angle of the mandible. Imaging suggested osteomyelitis but raised concern for malignancy. Surgical drainage was performed, and histopathology confirmed actinomycotic infection. The patient initially received empirical intravenous vancomycin, cefotaxime, and metronidazole. Due to persistent fever and elevated inflammatory markers, the regimen was switched to teicoplanin plus piperacillin/tazobactam. Therapy was subsequently escalated to meropenem due to recurrent fever and based on magnetic resonance imaging findings suggestive of osteomyelitis, then vancomycin was replaced with teicoplanin because of vancomycin-associated nephrotoxicity. Following clinical improvement, the patient was discharged on oral amoxicillin/clavulanate to complete a total of six weeks of therapy.

Discussion: Pediatric mandibular actinomycotic osteomyelitis is extremely rare. Its indolent course often mimics tumors or granulomatous disease. In this case, delayed diagnosis and nonspecific imaging findings led to initial misinterpretation. Surgical intervention played a key role in diagnosis and treatment. Early recognition and combined medical-surgical management are crucial to avoid complications. This case highlights the importance of considering infectious causes in mandibular masses and underscores the diagnostic challenges associated with them.