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Characterization of lingual microbiota in pediatric geographic tongue. 小儿地理舌的舌微生物群特征。
Pub Date : 2024-10-07 DOI: 10.24953/turkjpediatr.2024.4638
Yi You, Yuan He, Peicheng Huang

Background: Geographic tongue is an oral mucosal lesion affecting the tongue. The association between geographic tongue and the mucosal microbiota in children remains unclear.

Method: To characterize the feature of lingual microbiota in pediatric geographic tongue, lingual swabs were collected from lesion sites and healthy sites of 25 patients with geographic tongue (14 males and 11 females; age 5.21 ±2.94 years) and 19 controls (10 males and 9 females; age 5.31±2.82 years). DNA was extracted and the 16S rRNA was amplificated, sequenced and analyzed.

Results: The lingual microbiota composition was significantly different between children with geographic tongue and the healthy cohort; Streptobacillus was reduced in geographic tongue, while Catonella, Bacillus and Oribacterium were overrepresented. When the lesions and the normal mucosa were compared, an increased abundance of Prevotella oris was observed.

Conclusion: Our results provided new insight into the association between oral microbiota and pediatric geographic tongue.

背景介绍地包天是一种影响舌头的口腔黏膜病变。儿童地包天舌与粘膜微生物群之间的关系仍不清楚:为了描述小儿地包天舌舌黏膜微生物区系的特征,研究人员从25名地包天舌患者(男14名,女11名;年龄5.21±2.94岁)和19名对照组(男10名,女9名;年龄5.31±2.82岁)的病变部位和健康部位采集了舌拭子。研究人员提取了 DNA,并对 16S rRNA 进行了扩增、测序和分析:结果:舌炎患儿的舌微生物群组成与健康人群有显著差异;舌炎患儿的链球菌减少,而卡托奈氏菌、芽孢杆菌和奥里布氏菌的比例较高。将病变粘膜与正常粘膜进行比较,发现口腔普雷沃特氏菌的数量有所增加:我们的研究结果为了解口腔微生物群与小儿地包天之间的关系提供了新的视角。
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引用次数: 0
Diagnostic value and clinical significance of lncRNA NEAT1 combined with miR-425-3p in children with viral myocarditis. lncRNA NEAT1与miR-425-3p在病毒性心肌炎患儿中的诊断价值和临床意义。
Pub Date : 2024-10-07 DOI: 10.24953/turkjpediatr.2024.4579
Jielin Gao, Lili Qin, Qiaozhi Guo, Dongxia Zhao, Guomei Ma, Kuilong Zhou, Shuang Wang, Hengrui Hao

Background: Viral myocarditis (VMC) is common in children. Previous studies have reported the clinical value of nuclear paraspeckle assembly transcript 1 (NEAT1) and microRNA-425-3p (miR-425-3p) in certain diseases, but not in VMC. This article was designed to investigate the expression of long noncoding RNA (lncRNA) NEAT1 and miR-425-3p in the serum of patients with VMC and their clinical significance.

Methods: We assessed VMC and healthy patients and analyzed differences in the expression levels of NEAT1 and miR-425-3p. The correlation and targeting relationship between the two were reported by Spearman correlation analysis and luciferase reporter assay. ROC curves were plotted to reflect the diagnostic effect of both. In addition, according to the 12-month prognostic effect grouping, patients with VMC were separated into a group with good vs. poor prognosis, and the difference in the expression levels of NEAT1 and miR-425-3p between the two groups were analyzed. The ability of the two markers in the prognosis of VMC was further analyzed by multiple logistic regression.

Results: NEAT1 expression was up-regulated in VMC and miR-425-3p expression was down-regulated, and there was a negative correlation and targeting link between the two. The diagnostic efficacy of both NEAT1 and miR-425-3p was higher than that of a single indicator. High expression of NEAT1 and low expression of miR-425-3p were found in VMC patients with poor prognosis. Both were independent influencers of VMC prognosis.

Conclusion: NEAT1 and miR-425-3p expressions were affected by VMC and had important clinical implications for VMC, indicating for the first time the clinical function of NEAT1 and miR-425-3p in VMC.

背景:病毒性心肌炎(VMC)在儿童中很常见。以前的研究报道了核旁组装转录本 1(NEAT1)和 microRNA-425-3p(miR-425-3p)在某些疾病中的临床价值,但没有报道它们在 VMC 中的临床价值。本文旨在研究VMC患者血清中长非编码RNA(lncRNA)NEAT1和miR-425-3p的表达及其临床意义:我们对 VMC 患者和健康患者进行了评估,并分析了 NEAT1 和 miR-425-3p 的表达水平差异。通过斯皮尔曼相关分析和荧光素酶报告实验,报告了两者之间的相关性和靶向关系。绘制的 ROC 曲线反映了两者的诊断效果。此外,根据 12 个月的预后效果分组,将 VMC 患者分为预后良好组和预后不良组,分析两组间 NEAT1 和 miR-425-3p 表达水平的差异。结果发现,NEAT1表达上调,miR-425-3p表达下调:结果:NEAT1在VMC中表达上调,miR-425-3p表达下调,二者之间存在负相关和靶向联系。NEAT1和miR-425-3p的诊断效力均高于单一指标。在预后不良的 VMC 患者中发现了 NEAT1 的高表达和 miR-425-3p 的低表达。结论:NEAT1和miR-425-3p是VMC预后的独立影响因素:结论:NEAT1和miR-425-3p的表达受VMC影响,对VMC有重要的临床意义,首次表明了NEAT1和miR-425-3p在VMC中的临床功能。
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引用次数: 0
Extremely rare cause of hyperkalemia: ileostomy‒induced hyperkalemia in extremely low birth weight infants. 极为罕见的高钾血症病因:极低出生体重儿回肠造口术诱发的高钾血症。
Pub Date : 2024-07-11 DOI: 10.24953/turkjpediatr.2024.4541
Mehmet Mutlu, Yakup Aslan, Şebnem Kader, Emine Ayça Cimbek, Gül Şalcı

Background: Hyperkalemia is one of the most serious electrolyte disturbances, and it can cause lethal cardiac arrhythmia. Although hyperkalemia associated with ileostomies has been reported in adults, to the best of our knowledge, it has not previously been reported in neonates.

Case: We report ileostomy‒induced hyperkalemia that persisted during the ileostomy and resolved promptly after the closure of the ileostomy in two extremely low birth weight (ELBW) infants, with birth weights of 850 g and 840 g and gestational ages of 27 weeks and 27 weeks 6 days.

Conclusions: These cases highlight that disruption of intestinal integrity in ELBW infants may cause hyperkalemia. Ensuring the integrity of the gastrointestinal tract plays an important role in the treatment of electrolyte disorders such as hyperkalemia in ELBW infants with an ileostomy.

背景:高钾血症是最严重的电解质紊乱之一,可导致致命性心律失常。虽然成人中也有回肠造口术引起高钾血症的报道,但就我们所知,以前从未有新生儿出现高钾血症的报道:病例:我们报告了两个极低出生体重儿(ELBW)的回肠造口术诱发高钾血症的病例,这两个婴儿的出生体重分别为 850 克和 840 克,胎龄分别为 27 周和 27 周 6 天:这些病例突出表明,ELBW 婴儿肠道完整性的破坏可能会导致高钾血症。在治疗回肠造口术 ELBW 婴儿的电解质紊乱(如高钾血症)时,确保胃肠道的完整性起着重要作用。
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引用次数: 0
Subtle myocardial effects of rheumatic heart disease in children are revealed earlier with two-dimensional speckle tracking echocardiography 二维斑点追踪超声心动图能更早发现儿童风湿性心脏病对心肌的微妙影响
Pub Date : 2024-07-11 DOI: 10.24953/turkjpediatr.2024.4566
Hüseyin Ilgın Bal, İrem Türkyılmaz, Ş. Kayalı, Ayhan Kılıç
Objective. Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in developing countries and remains a serious public health problem. In the subclinical course of carditis, the absence of typical symptoms and the normal range of classical echocardiographic measurements used to evaluate cardiac functions have required new echocardiographic methods and parameters. Previous studies regarding rheumatic heart disease in children and adults have shown that strain patterns obtained by speckle tracking echocardiography, are in fact affected although left ventricular systolic functions are preserved, yet some studies have suggested otherwise. The aim of our study is to compare the use of speckle tracking echocardiography with conventional methods in the evaluation of cardiac functions and myocardial involvement in children with subclinical RHD.Materials and Methods. The study group consisted of 24 patients with asymptomatic cardiovascular who had no history of acute rheumatic fever, but had definite or probable rheumatic valve disease. This study group was determined according to the World Heart Federation guidelines by an echocardiographic examination performed for different reasons, as well as the control group of 22 healthy children. In order to evaluate the left ventricular regional myocardial functions of the patients, tissue Doppler echocardiography (TDE) and speckle tracking echocardiographic parameters were compared with the control group.Results. The mean ages of the patient and control groups were 14.1±2.7 years and 13.9±2.3 years, respectively. There was no statistically significant difference between the two groups in terms of conventional methods (p>0.05) but global longitudinal strain and strain rate values were found to be significantly lower in the patient group (p<0.01). These changes appeared to be relevant throughout the duration of the illness.Conclusion. In patients with subclinical rheumatic heart disease, conventional echocardiographic evaluations are likely negative, whereas two-dimensional speckle tracking echocardiography reveal systolic and diastolic dysfunctions of the disease.
目的。风湿性心脏病(RHD)是发展中国家最常见的后天性心脏病,仍然是一个严重的公共卫生问题。在心脏炎的亚临床病程中,由于没有典型症状,而且用于评估心脏功能的经典超声心动图测量值范围正常,因此需要新的超声心动图方法和参数。以往关于儿童和成人风湿性心脏病的研究表明,虽然左心室收缩功能保持不变,但斑点追踪超声心动图获得的应变模式实际上会受到影响,但也有一些研究提出了相反的观点。我们的研究旨在比较使用斑点追踪超声心动图和传统方法评估亚临床 RHD 儿童的心脏功能和心肌受累情况。研究组由 24 名无症状心血管患者组成,他们没有急性风湿热病史,但有明确或可能的风湿性瓣膜病。该研究组是根据世界心脏联盟的指南,通过因不同原因进行的超声心动图检查确定的,同时还包括由 22 名健康儿童组成的对照组。为了评估患者的左心室区域心肌功能,组织多普勒超声心动图(TDE)和斑点追踪超声心动图参数与对照组进行了比较。患者组和对照组的平均年龄分别为(14.1±2.7)岁和(13.9±2.3)岁。两组在常规方法上无明显统计学差异(P>0.05),但发现患者组的整体纵向应变和应变率值明显较低(P<0.01)。这些变化似乎与整个病程有关。在亚临床风湿性心脏病患者中,常规超声心动图评估很可能是阴性的,而二维斑点追踪超声心动图可显示疾病的收缩和舒张功能障碍。
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引用次数: 0
Prognostic significance of mean platelet volume to platelet count ratio in pediatric patients with acute kidney injury 急性肾损伤儿科患者平均血小板体积与血小板计数比值的预后意义
Pub Date : 2024-07-11 DOI: 10.24953/turkjpediatr.2024.4514
Kübra Çeleğen, M. Çeleğen
Background. Mean platelet volume (MPV), which is regarded as a marker of thrombocyte function and activation, is related to increased morbidity and mortality. In critically ill patients, the ratio of MPV to platelets can independently predict adverse outcomes. This study aimed to investigate the prognostic value of the mean platelet volume/platelet count ratio (MPR) for mortality in children with acute kidney injury (AKI).Methods. In this retrospective study, patients hospitalized in the pediatric intensive care unit (PICU) between March 2020 and June 2022 were evaluated. Patients between 1 month and 18 years of age with AKI were enrolled. Clinical and laboratory data were compared between survivors and non-survivors. The MPR ratio was calculated on the first and third days of admission to the intensive care unit. A multiple logistic regression analysis was used to determine the association between MPR and mortality. ROC curves were used for the prediction performance of the logistic regression models and cut-off values of the thrombocyte indices.Results. Sixty-three children with AKI were included in the study. The total mortality rate was 34.9% (n=22). MPR ratios were significantly higher in the non-survivors at admission (p=0.042) and at the 72nd hour (p=0.003). In the multiple logistic regression analysis, thrombocyte counts and MPR72h ratio were found to be independent risk parameters for adverse outcomes in children with AKI.Conclusions. MPR is an inexpensive and practical marker that may predict the outcome of children with AKI.
背景。血小板平均体积(MPV)被认为是血小板功能和活化的标志,它与发病率和死亡率的增加有关。在重症患者中,MPV 与血小板的比率可独立预测不良预后。本研究旨在探讨平均血小板体积/血小板计数比值(MPR)对急性肾损伤(AKI)患儿死亡率的预后价值。在这项回顾性研究中,对 2020 年 3 月至 2022 年 6 月期间在儿科重症监护室(PICU)住院的患者进行了评估。年龄在1个月至18岁之间的AKI患者均被纳入研究范围。幸存者和非幸存者的临床和实验室数据进行了比较。在入住重症监护室的第一天和第三天计算MPR比率。采用多元逻辑回归分析确定 MPR 与死亡率之间的关系。ROC曲线用于评估逻辑回归模型的预测性能和血小板指数的临界值。研究共纳入63名AKI患儿。总死亡率为 34.9%(22 人)。入院时(P=0.042)和72小时时(P=0.003),非存活者的MPR比率明显较高。在多重逻辑回归分析中发现,血小板计数和 MPR72h 比率是导致 AKI 患儿不良预后的独立风险参数。MPR是一种廉价而实用的标记物,可预测AKI患儿的预后。
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引用次数: 0
The relationship between lung function, exercise capacity, oxidant and antioxidant response in primary ciliary dyskinesia and cystic fibrosis. 原发性睫状肌运动障碍和囊性纤维化患者的肺功能、运动能力、氧化和抗氧化反应之间的关系。
Pub Date : 2024-07-11 DOI: 10.24953/turkjpediatr.2024.4581
Yasemin Kartal, Cemile Bozdemir Özel, Aslıhan Çakmak, Hazal Sonbahar Ulu, Deniz İnal İnce, Dilber Ademhan Tural, Sanem Eryılmaz Polat, Mina Hızal, Uğur Özçelik, Sevilay Karahan, Murat Timur Budak, Gözde Girgin, Hülya Arıkan, Suna Sabuncuoğlu

Background: There is a need to identify the complex interplay between various physiological mechanisms in primary ciliary dyskinesia (PCD) and cystic fibrosis (CF). The study investigated the interaction between respiratory function, exercise capacity, muscle strength, and inflammatory and oxidant/antioxidant responses in patients with PCD and CF.

Methods: The study included 30 PCD patients, 30 CF patients, and 29 age and sex-matched healthy subjects. Exercise capacity was assessed using the modified shuttle walk test (MSWT). Handgrip strength (HGS) was used to evaluate general muscle strength. Oxidative stress-inflammatory parameters were also assessed. Pulmonary function test was performed by spirometry. Regarding the forced expiratory volume in 1 second (FEV1) z-score, patients with PCD and CF were subdivided into normal, mild, and severe/moderate groups.

Results: Forced vital capacity (FVC) z-scores were lower in PCD and CF patients than controls. FEV1, FEV1/FVC, peak expiratory flow (PEF), and forced mid expiratory flow (FEF25-75%) z-scores were lower in PCD than in the other groups. HGS was lower in both mild PCD and normal CF patients relative to the controls. MSWT distance was lower in severe/moderate PCD patients than controls. Catalase (CAT), glutathione S-transferase (GST), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels did not differ significantly among the study groups, but superoxide dismutase (SOD) level in severe/moderate PCD, and glutathione (GSH) level in normal CF were higher than in controls. Interleukin-6 (IL-6) level was higher in patients with normal PCD and CF compared to the controls. IL-1β level was higher in PCD compared to controls. Additionally, correlations among these parameters were also determined in some patient groups.

Conclusion: Homeostasis related to respiratory function, aerobic performance, muscle strength, inflammatory response, and oxidant/antioxidant balance were affected in PCD and CF. Evaluating these mechanisms together may contribute to elucidating the pathophysiology of these rare diseases.

背景:需要确定原发性睫状肌运动障碍(PCD)和囊性纤维化(CF)中各种生理机制之间复杂的相互作用。本研究调查了 PCD 和 CF 患者的呼吸功能、运动能力、肌肉力量以及炎症和氧化/抗氧化反应之间的相互作用:研究对象包括 30 名 PCD 患者、30 名 CF 患者和 29 名年龄与性别匹配的健康受试者。采用改良穿梭步行测试(MSWT)评估运动能力。手握力(HGS)用于评估全身肌肉力量。此外,还对氧化应激-炎症参数进行了评估。肺功能测试通过肺活量测定法进行。根据 1 秒用力呼气容积(FEV1)的 Z 值,将 PCD 和 CF 患者细分为正常组、轻度组和重度/中度组:结果:与对照组相比,PCD 和 CF 患者的用力肺活量(FVC)z-评分较低。肺结核患者的 FEV1、FEV1/FVC、呼气峰流速(PEF)和用力呼气中期流速(FEF25-75%)z-分数均低于其他组别。与对照组相比,轻度 PCD 患者和正常 CF 患者的 HGS 均较低。重度/中度 PCD 患者的 MSWT 距离低于对照组。各研究组的过氧化氢酶(CAT)、谷胱甘肽 S-转移酶(GST)、谷胱甘肽过氧化物酶(GPx)和丙二醛(MDA)水平无显著差异,但重度/中度 PCD 患者的超氧化物歧化酶(SOD)水平和正常 CF 患者的谷胱甘肽(GSH)水平均高于对照组。与对照组相比,正常 PCD 和 CF 患者的白细胞介素-6(IL-6)水平较高。与对照组相比,PCD 患者的 IL-1β 水平更高。此外,在一些患者组中还发现了这些参数之间的相关性:结论:在 PCD 和 CF 患者中,与呼吸功能、有氧表现、肌肉力量、炎症反应和氧化剂/抗氧化剂平衡有关的平衡受到影响。综合评估这些机制可能有助于阐明这些罕见疾病的病理生理学。
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引用次数: 0
A surprise during hernia surgery: inguinoscrotal megaureter 疝气手术中的惊喜:阴囊内巨输尿管
Pub Date : 2024-07-08 DOI: 10.24953/turkjpediatr.2024.4755
Gonca Gerçel
Background. Ureteroinguinal herniation is a rare occurrence that is typically diagnosed during the surgical repair of inguinal hernias.Case Presentation. We present the case of a 4-year-old male who underwent inguinal hernia repair, during which a megaureter was discovered within the hernia sac. The surgical intervention included high ligation of the hernial sac and repositioning of the ureter back into the retroperitoneum. Postoperative investigations confirmed a diagnosis of primary non-refluxing and nonobstructive megaureter.Conclusion. Although ureteral herniation is rare in infants, it is crucial to remain vigilant about the possibility of encountering the ureter during hernia repair to prevent potential ureteral injuries. Additionally, any associated urinary tract anomalies should be thoroughly investigated and ruled out.
背景。输尿管腹股沟疝是一种罕见病,通常在腹股沟疝的手术修复过程中被诊断出来。病例介绍:一名 4 岁的男性接受了腹股沟疝修补术,术中发现疝囊内有巨输尿管。手术治疗包括疝囊高位结扎和将输尿管复位至腹膜后。术后检查确诊为原发性非反流、非梗阻性巨输尿管。尽管输尿管疝在婴儿中很少见,但在疝修补术中仍要警惕遇到输尿管的可能性,以防止潜在的输尿管损伤。此外,应彻底检查并排除任何相关的泌尿道异常。
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引用次数: 0
The predictive role of lung clearance index on FEV1 decline in cystic fibrosis 肺清除指数对囊性纤维化患者 FEV1 下降的预测作用
Pub Date : 2024-07-08 DOI: 10.24953/turkjpediatr.2024.4516
B. Özsezen, Ebru Yalçın, N. Emiralioğlu, Hande Konşuk Ünlü, D. Ademhan Tural, Canan Caka, B. Sunman, D. Doğru, U. Özçelik, N. Kiper
Background. The lung clearance index (LCI) is a sensitive lung function index that is used to detect early lung disease changes in children with cystic fibrosis (CF). This study aimed to define the predictive role of baseline LCI, along with other potential factors on the change in forced expiratory volume in one second (FEV1) during one-year follow-up in CF patients who had a percent predicted (pp) FEV1≥80.Methods. LCI was concurrently performed on 57 CF patients who had ppFEV1 ≥80 at month zero. The ppFEV1 decline was evaluated prospectively during the one year follow up. The primary outcome of ppFEV1 decline in the study group in one year was dichotomized according to the median value for the decline in ppFEV1, which was 3.7. The LCI value predicting ppFEV1 decline at the end of one year was calculated with receiver operating characteristic curve analysis. Regression analysis was performed. Furthermore, a decision tree was constructed using classification and regression tree methods to better define the potential effect of confounders on the ppFEV1 decline.Results. The LCI value for predicting ppFEV1 decline >3.7% at the end of one year was 8.2 (area under the curve: 0.80) Multivariable regression analysis showed that the absence of the F508del mutation in at least one allele, LCI >8.2 and initial FEV1 z-score were predictors of a ppFEV1 decline >3.7 (p<0.001). Factors altering ppFEV1 decline>3.7% at the end of one-year evaluated by decision trees were as follows: initial FEV1 z-score, type of CFTR mutation, LCI value and initial weight-for-age z-score.Conclusions. LCI is sensitive for predicting ppFEV1 decline in patients with ppFEV1 ≥80 along with the initial FEV1-z-score and type of CFTR mutation.
背景。肺清除指数(LCI)是一种敏感的肺功能指数,用于检测囊性纤维化(CF)儿童早期肺部疾病的变化。本研究旨在确定基线 LCI 及其他潜在因素对 FEV1 预测值(pp)≥80 的 CF 患者一年随访期间一秒用力呼气容积(FEV1)变化的预测作用。对 57 名在第 0 个月时ppFEV1 ≥80 的 CF 患者同时进行了 LCI。在一年的随访期间,对ppFEV1的下降情况进行了前瞻性评估。研究组一年内ppFEV1下降的主要结果根据ppFEV1下降的中位值(3.7)进行二分。通过接收器操作特征曲线分析,计算出预测一年后ppFEV1下降的LCI值。进行了回归分析。此外,还利用分类和回归树方法构建了一棵决策树,以更好地确定混杂因素对ppFEV1下降的潜在影响。预测一年后ppFEV1下降>3.7%的LCI值为8.2(曲线下面积:0.80)。2和初始FEV1 z-score是预测ppFEV1下降>3.7(一年结束时p3.7%)的因素。LCI与初始FEV1-z-score和CFTR突变类型一起,可灵敏预测ppFEV1≥80患者的ppFEV1下降。
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引用次数: 0
Gastroenteropancreatic neuroendocrine tumors in children and adolescents 儿童和青少年的胃肠胰神经内分泌肿瘤
Pub Date : 2024-07-08 DOI: 10.24953/turkjpediatr.2024.4526
Ülkü Miray Yıldırım, Dilşad Koca, R. Kebudi
Background. Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare in children and adolescents. Standard management of these tumors has not been well established due to their rarity in this age group. We aimed to report the clinical and pathological characteristics of patients with this rare disease followed and treated between the years 1993-2022.Materials and methods. The medical records of patients with GEP-NETs were reviewed.Results. Fourteen patients (11 girls, 3 boys) were diagnosed with GEP-NET. The median age was 13 (9-18) years. Tumor localization was the appendix in 12, stomach in one and pancreas in one patient. Mesoappendix invasion was detected in four patients two of whom underwent right hemicolectomy (RHC) and lymph node dissection (LND). Of those, one patient had lymph node involvement. The other two had not further operations. Somatostatin was used in one with pancreatic metastatic disease and the other with gastric disease after surgery. No additional treatment was given in other patients. All patients are under follow-up without evidence of disease at a median follow-up of 85 months (7-226 months).Conclusion. GEP-NETs should be considered in the differential diagnosis of acute appendicitis and in cases with persistent abdominal pain. In children, there is invariably a favorable prognosis, and additional surgical interventions other than simple appendectomies generally do not provide benefits. Mesoappendix invasion may not necessitate RHC and LND.
背景。胃肠胰神经内分泌肿瘤(GEP-NET)在儿童和青少年中非常罕见。由于这些肿瘤在这一年龄组的罕见性,其标准治疗方法尚未得到很好的确立。我们旨在报告 1993-2022 年间随访和治疗的这种罕见疾病患者的临床和病理特征。我们回顾了 GEP-NET 患者的病历。14名患者(11名女孩,3名男孩)被确诊为GEP-NET。中位年龄为13(9-18)岁。12名患者的肿瘤位于阑尾,1名患者位于胃部,1名患者位于胰腺。四名患者发现阑尾中叶受侵,其中两人接受了右半结肠切除术(RHC)和淋巴结清扫术(LND)。其中一名患者淋巴结受累。另外两名患者没有进行进一步手术。其中一名患者患有胰腺转移性疾病,另一名患者在手术后患有胃部疾病,因此使用了体生长抑素。其他患者没有接受额外治疗。所有患者都在接受随访,中位随访时间为 85 个月(7-226 个月),无疾病迹象。结论:在急性阑尾炎的鉴别诊断和持续腹痛的病例中,应考虑GEP-NET。在儿童中,预后总是良好的,除了简单的阑尾切除术外,额外的外科干预一般不会带来益处。阑尾中段受侵可能不需要进行 RHC 和 LND。
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引用次数: 0
Has the COVID-19 pandemic negatively impacted children’s development? An assessment of the neurodevelopment of premature babies born during the pandemic COVID-19 大流行是否对儿童发育产生了负面影响?对大流行期间早产儿神经发育的评估
Pub Date : 2024-07-03 DOI: 10.24953/turkjpediatr.2024.4551
Emel Ömercioğlu, Ece Naz, Mert Karakaya, Gökçenur Özdemir, Buse Şencan Karakuş, Şeyma Kılınç, H. C. İskender, Ebru Cihan Çam, Ayşe Mete, H. Çelik, S. Karahan, Elif N. Özmert
Background. Pandemics, such as COVID-19, have the potential to adversely affect children’s development due to a variety of negative factors at the level of children, families, and services. In this study the effect of the pandemic on the cognitive, language and motor development of premature babies who are among the most vulnerable group, were evaluated.Methods. The study included 236 premature infants who were followed at Hacettepe University Department of Developmental Pediatrics. The Bayley-Third Edition Developmental Assessment (Bayley III) was used to evaluate the neurodevelopment of 152 premature infants from the pre-pandemic group and 84 from the post-pandemic group at the corrected age of 18–24 months. The perinatal and sociodemographic risks were also evaluated.Results. No difference in Bayley III scores (cognitive, language, and motor) was found between the pre- and post-pandemic groups. Furthermore, the multivariate covariance analysis displayed that regardless of the pandemic, infants with higher maternal education consistently scored higher in the cognitive, language, and motor domains; and the motor area scores of infants with moderate perinatal risk were also significantly higher than infants with high perinatal risk.Conclusions. It is crucial to monitor the development of vulnerable children who encounter developmental risks, such as premature babies. Fortunately, no significant effect was encountered during the COVID-19 pandemic. However, this does not underweigh the need for close supervision in extraordinary circumstances. Additionally, it should be noted that severe postnatal comorbidities, perinatal risks, and social factors, such as maternal education level, interact to influence the neurodevelopmental outcomes of preterm infants.
背景。COVID-19 等大流行病可能会对儿童的发展产生不利影响,这是由儿童、家庭和服务等层面的各种负面因素造成的。本研究评估了大流行对早产儿认知、语言和运动发展的影响,早产儿是最易受影响的群体之一。研究对象包括哈杰泰佩大学发育儿科系的 236 名早产儿。贝利第三版发育评估(Bayley III)用于评估流行前组的 152 名早产儿和流行后组的 84 名早产儿在 18-24 个月校正年龄时的神经发育情况。此外,还对围产期风险和社会人口风险进行了评估。大流行前和大流行后两组婴儿的 Bayley III 评分(认知、语言和运动)没有差异。此外,多变量协方差分析显示,无论大流行与否,母亲教育程度较高的婴儿在认知、语言和运动领域的得分一直较高;围产期风险中等的婴儿的运动领域得分也明显高于围产期风险高的婴儿。对早产儿等面临发育风险的弱势儿童进行发育监测至关重要。幸运的是,在 COVID-19 大流行期间没有出现明显的影响。不过,这并不影响在特殊情况下进行密切监护的必要性。此外,应该注意的是,严重的产后合并症、围产期风险和社会因素(如母亲的教育水平)相互作用,影响早产儿的神经发育结果。
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The Turkish journal of pediatrics
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