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Rehospitalization indications of children hospitalized for COVID-19 infections and long COVID. 因感染 COVID-19 和长 COVID 而住院的儿童的再住院指征。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.670
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
In light of recent discoveries: Breastfeeding is more than nutrition for term and preterm babies. 根据最新发现:对足月儿和早产儿来说,母乳喂养不仅仅是营养。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.656
Gözdem Kaykı, Şule Yiğit
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引用次数: 0
Management of pediatric hemolytic uremic syndrome. 小儿溶血性尿毒症综合征的管理。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.596
Bora Gülhan, Fatih Özaltın, Kibriya Fidan, Zeynep Birsin Özçakar, Oğuz Söylemezoğlu

Classical clinical triad of hemolytic uremic syndrome (HUS) is microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury associated with endothelial cell injury. Several situations, including infections, medications, malignancies, and transplantation can trigger endothelial damage. On the HUS spectrum, atypical hemolytic uremic syndrome (aHUS) deserves special attention in pediatric patients, as it can cause endstage kidney disease and mortality. A dysfunction in the alternative complement pathway, either acquired or genetic, has been shown to be the main underlying cause. In the last decades, breathtaking advances have been made in understanding the pathophysiology of this rare disease, which has led to more efficient treatment. Recent studies have implicated genes in pathways beyond the alternative complement system, such as DGKE, TSEN2, and INF2 highlighting the importance of personalized management. Eculizumab has brought about dramatic improvements in the treatment of aHUS. Beyond eculizumab, there are many alternative therapeutics in the pipeline that target the complement system. Because of the rarity of aHUS, data from multiple patient registries are very important. The present report aimed to summarize the most important aspects of diagnosing and treating aHUS based on the Turkish national registry and the literature so as to improve clinical practice.

溶血性尿毒症综合征(HUS)的经典临床三联征是与内皮细胞损伤相关的微血管病性溶血性贫血、血小板减少和急性肾损伤。感染、药物、恶性肿瘤和移植等多种情况都可能引发内皮细胞损伤。在 HUS 病谱中,非典型溶血性尿毒症综合征(aHUS)值得儿童患者特别注意,因为它可导致终末期肾病和死亡。替代补体途径的功能障碍(获得性或遗传性)已被证明是主要的根本原因。在过去的几十年中,人们在了解这种罕见疾病的病理生理学方面取得了令人惊叹的进展,从而提高了治疗效率。最近的研究发现,替代补体系统以外的通路中也存在基因,如 DGKE、TSEN2 和 INF2,这凸显了个性化管理的重要性。依库珠单抗为治疗 aHUS 带来了巨大的进步。除了依库珠单抗,还有许多针对补体系统的替代疗法正在研发中。由于 aHUS 的罕见性,来自多个患者登记处的数据非常重要。本报告旨在根据土耳其国家登记资料和文献总结诊断和治疗 aHUS 的最重要方面,以改进临床实践。
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引用次数: 0
The importance of transient hypothyroxinemia of prematurity and its controversial management. 早产儿一过性甲状腺功能减退症的重要性及其有争议的治疗方法。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.744
Ümit Ayşe Tandırcıoğlu, Serdar Alan
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引用次数: 0
Concurrent pyoderma gangrenosum and Takayasu arteritis in an infant: diagnostic challenges and treatment considerations. 一名婴儿同时患有脓皮病和高安氏动脉炎:诊断难题和治疗注意事项。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.714
Gülcan Özomay Baykal, Betül Sözeri

Background: Takayasu arteritis (TA) is an uncommon chronic inflammatory and autoimmune disease primarily affecting large vessels, particularly the aorta and its branches. Skin manifestations have been documented in association with TA. Pyoderma gangrenosum (PG) is a chronic neutrophilic dermatosis characterized by destructive, necrotizing, and painful ulcers, predominantly found on the lower extremities. The coexistence of PG and TA is extremely rare, with most reported cases involving adult patients. Interestingly, the association between PG and TA appears to be more common in Japan compared to North American and European populations. Childhood TA (c-TA) accompanied by PG is exceptionally rare, with only 10 cases reported in the literature thus far.

Case report: We present the case of a 7-month-old patient initially diagnosed with PG. Despite aggressive immunosuppressive therapy, the patient`s high acute phase reactants remained elevated. Although the abdominal ultrasound was normal, advanced imaging was performed due to severe abdominal pain. Contrastenhanced computerized tomography angiography of the aorta and its branches revealed extensive vascular involvement consistent with TA.

Conclusion: In this report, we highlight an infantile case of PG that was subsequently diagnosed as infantile TA. Recognizing the rare association between PG and TA is important. Thorough evaluation and prompt diagnosis of TA in infants with PG can guide further investigations and prevent vascular complications.

背景:高安动脉炎(TA)是一种不常见的慢性炎症和自身免疫性疾病,主要影响大血管,尤其是主动脉及其分支。有记录表明,皮肤表现与高安动脉炎有关。坏疽性脓皮病(PG)是一种慢性嗜中性皮肤病,以破坏性、坏死性和疼痛性溃疡为特征,主要发生在下肢。PG和TA同时存在的情况极为罕见,大多数报道的病例涉及成年患者。有趣的是,与北美和欧洲人群相比,PG 和 TA 的关联似乎在日本更为常见。伴有 PG 的儿童 TA(c-TA)异常罕见,迄今只有 10 例文献报道:本病例是一名 7 个月大的患者,最初被诊断为 PG。尽管接受了积极的免疫抑制治疗,但患者的急性期反应物仍然很高。虽然腹部超声检查正常,但由于腹部剧痛,患者接受了高级造影检查。主动脉及其分支的对比增强计算机断层扫描血管造影显示广泛的血管受累,与 TA 一致:在本报告中,我们重点介绍了一例随后被诊断为小儿 TA 的小儿 PG。认识到 PG 和 TA 之间的罕见关联非常重要。对患有 PG 的婴儿进行彻底评估并及时诊断为 TA,可指导进一步检查并预防血管并发症。
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引用次数: 0
Evaluation of childhood malignancies presenting with musculoskeletal manifestations from two different divisions: a multicenter study. 评估来自两个不同部门、伴有肌肉骨骼表现的儿童恶性肿瘤:一项多中心研究。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.446
Şengül Çağlayan, Begüm Şirin Koç, Özge Baba, Esra Bağlan, Burçak Kurucu, Deniz Gezgin Yıldırım, Aylin Canbolat Ayhan, Mustafa Çakan, Gülçin Otar Yener, Kübra Öztürk, Figen Çakmak, Hafize Emine Sönmez, Nuray Aktay Ayaz, Ayşenur Paç Kısaarslan, Sevcan Bakkaloğlu, Mukaddes Kalyoncu, Suar Çakı Kılıç, Betül Sözeri

Background: The aim of the study was to evaluate the approaches of pediatric rheumatologists and pediatric hematologists to patients with similar musculoskeletal (MSK) complaints and to highlight the differences that general pediatricians should consider when referring patients to these specialties.

Methods: This is a cross-sectional study involving the patients who applied to pediatric rheumatology centers with MSK complaints and were diagnosed with malignancy, as well as patients who were followed up in pediatric hematology centers with a malignancy diagnosis, and had MSK complaints at the time of admission.

Results: A total of 142 patients were enrolled in the study. Of these patients, 83 (58.4%) applied to pediatric rheumatology centers, and 59 (41.6%) applied to pediatric hematology centers. Acute lymphoblastic leukemia (ALL) was the most common diagnosis among the patients who applied to both centers, with 80 cases (56.3%). The median age of diagnosis was 87 (interquartile range, IQR: 48-140) months. The most common preliminary diagnosis in pediatric rheumatology centers was juvenile idiopathic arthritis (JIA), with 37 cases (44.5%). MSK involvement was mainly seen as arthralgia, and bone pain. While arthralgia (92.7%) was the most common complaint in rheumatology centers, bone pain (88.1%) was more common in hematology centers. The most frequently involved joints were the knee (62.9%), ankle (25.9%), hip (25%), and wrist (14%). The most common laboratory abnormalities were high lactate dehydrogenase (LDH), high C-reactive protein (CRP), anemia, and high erythrocyte sedimentation rate (ESR). Thrombocytopenia, neutropenia, and high LDH were statistically significantly more frequent in patients admitted to hematology centers than in patients admitted to rheumatology centers (p < 0.001, p=0.014, p=0.028, respectively). Patients who applied to rheumatology clinics were found to have statistically significantly higher CRP levels (p=0.032).

Conclusions: Malignancies may present with only MSK system complaints in childhood. Therefore, malignancies should be included in the differential diagnosis of patients presenting with MSK complaints.

研究背景本研究旨在评估儿科风湿病学家和儿科血液病学家对具有类似肌肉骨骼(MSK)主诉的患者的治疗方法,并强调普通儿科医生在将患者转诊至这些专科时应考虑的差异:这是一项横断面研究,研究对象包括向儿科风湿病中心提出申请并被确诊为恶性肿瘤的MSK主诉患者,以及在儿科血液病中心接受随访并被确诊为恶性肿瘤的患者,他们在入院时都有MSK主诉:共有 142 名患者参与了研究。在这些患者中,83人(58.4%)向儿科风湿病中心提出申请,59人(41.6%)向儿科血液病中心提出申请。急性淋巴细胞白血病(ALL)是向这两个中心申请的患者中最常见的诊断,共有 80 例(56.3%)。诊断年龄的中位数为87个月(四分位间距:48-140)。儿科风湿病中心最常见的初步诊断是幼年特发性关节炎(JIA),共有 37 例(44.5%)。MSK 受累主要表现为关节痛和骨痛。关节痛(92.7%)是风湿病中心最常见的主诉,而骨痛(88.1%)在血液病中心更为常见。最常受累的关节是膝关节(62.9%)、踝关节(25.9%)、髋关节(25%)和腕关节(14%)。最常见的实验室异常是乳酸脱氢酶(LDH)高、C反应蛋白(CRP)高、贫血和红细胞沉降率(ESR)高。从统计学角度看,血液病中心收治的患者中血小板减少、中性粒细胞减少和乳酸脱氢酶偏高的情况明显多于风湿病中心收治的患者(分别为 p < 0.001、p=0.014、p=0.028)。在风湿病诊所就诊的患者CRP水平明显更高(P=0.032):结论:恶性肿瘤在儿童期可能仅表现为多发性硬化症。因此,恶性肿瘤应被纳入出现 MSK 主诉的患者的鉴别诊断中。
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引用次数: 0
Comparison of the adolescent pregnancy outcomes between refugees and Turkish citizens. 难民与土耳其公民少女怀孕结果的比较。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.812
Oğuz Arslan, Burak Giray, Niyazi Tuğ

Background: Adolescent pregnant women have significant risk factors in terms of preterm birth, low birth weight, gestational and neonatal complications, and neonatal and infant deaths. In many countries, living as a refugee differs from living as a local citizen regarding education level, access to health services, and lifestyle. We aimed to compare the obstetric, perinatal, and neonatal outcomes of Turkish and refugee adolescent pregnant women admitted to a tertiary maternity center.

Methods: The study was planned as a retrospective cross-sectional. We included adolescent pregnant women who delivered between February 2018 and August 2023. Adolescent pregnant women were divided into two groups, the Turkish group and the Syrian refugee group, and compared with each other.

Results: One thousand and fifty-one Turkish and 742 refugee adolescent pregnant women were included in the study. Adolescent pregnancy rates are higher in refugees than in the Turkish group (p < 0.001). We found that maternal age (p < 0.001), preeclampsia rates (p=0.029), gestational age at delivery (p < 0.001), and cesarean delivery rates (p=0.02) were lower in refugee adolescent pregnant women. Furthermore, we found that the anemia rates (p < 0.001) and low birth weight newborn rates (p = 0.011) were higher in refugee adolescent pregnant women.

Conclusions: Enhancing the outcomes of adolescent pregnancies among refugees necessitates a heightened focus on education regarding sexual reproduction, increased prenatal follow-ups, and enhanced training in family planning.

背景:少女孕妇在早产、出生体重不足、妊娠并发症和新生儿并发症、新生儿和婴儿死亡等方面有很大的风险因素。在许多国家,作为难民的生活与作为当地公民的生活在教育水平、获得医疗服务和生活方式方面有所不同。我们的目的是比较在一家三级产科中心住院的土耳其和难民少女孕妇的产科、围产期和新生儿结局:研究计划为回顾性横断面研究。我们纳入了在2018年2月至2023年8月期间分娩的少女孕妇。青春期孕妇分为两组,即土耳其组和叙利亚难民组,并进行比较:研究共纳入了 151 名土耳其少女孕妇和 742 名难民少女孕妇。难民的少女怀孕率高于土耳其组(p < 0.001)。我们发现,难民少女孕妇的产妇年龄(p < 0.001)、先兆子痫发生率(p=0.029)、分娩胎龄(p < 0.001)和剖宫产率(p=0.02)均较低。此外,我们还发现难民少女孕妇的贫血率(p < 0.001)和新生儿低出生体重率(p = 0.011)较高:结论:要改善难民少女怀孕的结果,就必须更加重视有关性生殖的教育,增加产前随访,并加强计划生育方面的培训。
{"title":"Comparison of the adolescent pregnancy outcomes between refugees and Turkish citizens.","authors":"Oğuz Arslan, Burak Giray, Niyazi Tuğ","doi":"10.24953/turkjped.2023.812","DOIUrl":"10.24953/turkjped.2023.812","url":null,"abstract":"<p><strong>Background: </strong>Adolescent pregnant women have significant risk factors in terms of preterm birth, low birth weight, gestational and neonatal complications, and neonatal and infant deaths. In many countries, living as a refugee differs from living as a local citizen regarding education level, access to health services, and lifestyle. We aimed to compare the obstetric, perinatal, and neonatal outcomes of Turkish and refugee adolescent pregnant women admitted to a tertiary maternity center.</p><p><strong>Methods: </strong>The study was planned as a retrospective cross-sectional. We included adolescent pregnant women who delivered between February 2018 and August 2023. Adolescent pregnant women were divided into two groups, the Turkish group and the Syrian refugee group, and compared with each other.</p><p><strong>Results: </strong>One thousand and fifty-one Turkish and 742 refugee adolescent pregnant women were included in the study. Adolescent pregnancy rates are higher in refugees than in the Turkish group (p < 0.001). We found that maternal age (p < 0.001), preeclampsia rates (p=0.029), gestational age at delivery (p < 0.001), and cesarean delivery rates (p=0.02) were lower in refugee adolescent pregnant women. Furthermore, we found that the anemia rates (p < 0.001) and low birth weight newborn rates (p = 0.011) were higher in refugee adolescent pregnant women.</p><p><strong>Conclusions: </strong>Enhancing the outcomes of adolescent pregnancies among refugees necessitates a heightened focus on education regarding sexual reproduction, increased prenatal follow-ups, and enhanced training in family planning.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"66 1","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Isolated mitral valve aneurysm in a 9-year old boy. 一名 9 岁男孩的孤立性二尖瓣动脉瘤。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.314
Vehbi Doğan, Kutay Sel

Background: Isolated mitral valve aneurysm is rarely reported in children. In most cases it is associated with an underlying disease such as infective endocarditis. MVA can lead to severe complications that needs surgical intervention.

Case: In this report, we present a 9-year old asymptomatic male patient with anterior mitral valve aneurysm and rhythm disturbance diagnosed incidentally during pre-operative evaluation.

Conclusions: Being rare in children, isolated MVA should be kept in mind in the differential diagnosis of mass lesions seen on the atrial side of the mitral valve. A 24-hour electrocardiogram may define subtle rhythm disturbances in these patients.

背景:儿童中很少有孤立性二尖瓣动脉瘤的报道。大多数情况下,二尖瓣动脉瘤与感染性心内膜炎等潜在疾病有关。病例:在本报告中,我们介绍了一名无症状的 9 岁男性患者,他患有二尖瓣前动脉瘤和心律紊乱,在术前评估中偶然被诊断出来:孤立的二尖瓣前动脉瘤在儿童中较为罕见,在鉴别诊断二尖瓣心房侧肿块病变时应牢记这一点。24 小时心电图可确定这些患者是否存在微妙的心律紊乱。
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引用次数: 0
The earthquake disaster in Türkiye: a perspective on newborn evacuation and an ophthalmological approach. 图尔基耶地震灾难:新生儿疏散和眼科方法透视。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.564
Püren Işık, Selçuk Sızmaz, Ebru Esen, Ferda Özlü, Nihal Demircan
{"title":"The earthquake disaster in Türkiye: a perspective on newborn evacuation and an ophthalmological approach.","authors":"Püren Işık, Selçuk Sızmaz, Ebru Esen, Ferda Özlü, Nihal Demircan","doi":"10.24953/turkjped.2023.564","DOIUrl":"10.24953/turkjped.2023.564","url":null,"abstract":"","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"66 1","pages":"113-115"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A child with intravascular fasciitis mimicking deep vein thrombosis: a case report. 一例儿童血管内筋膜炎模仿深静脉血栓形成的病例报告。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.442
Yeşim Yiğit, Oğuzhan Erdoğan, Ayşen Türedi Yıldırım, Erdener Özer, Hüseyin Gülen

Background: Intravascular fasciitis (IF) is a benign, reactive, myofibroblastic proliferation that originates from the superficial or deep fascia of small / medium-sized arteries and veins.

Case report: An 8-year-old male patient was admitted to a health center with the complaint of swelling in the inguinal region. Lower extremity venous Doppler ultrasonography showed deep vein thrombosis (DVT) of the femoral vein and anticoagulation with low-molecular weight heparin (LMWH) was initiated. The patient was referred to our center for follow-up. The D-dimer level was detected within normal limits. Doppler ultrasonography was repeated and showed an intraluminal expanding mass lesion with increasing vascularity, without distinct borders and LMWH was discontinued. This lesion at the sapheno-femoral junction was excised surgically and the histopathological examination revealed intravascular fasciitis.

Conclusion: Clinicians should be aware that the clinical findings of IF may mimic sarcoma and thrombosis.

背景:血管内筋膜炎(IF)是一种良性、反应性、肌纤维增生,起源于小/中型动脉和静脉的浅层或深层筋膜:一名 8 岁的男性患者因腹股沟区肿胀而被送往一家医疗中心。下肢静脉多普勒超声检查显示股静脉深静脉血栓形成(DVT),并开始使用低分子量肝素(LMWH)进行抗凝治疗。患者被转到本中心进行随访。经检测,D-二聚体水平在正常范围内。再次进行多普勒超声检查,结果显示管腔内肿块病变扩大,血管增多,边界不清,因此停用了 LMWH。手术切除了这个位于隐股交界处的病灶,组织病理学检查显示为血管内筋膜炎:临床医生应该意识到,血管内筋膜炎的临床表现可能与肉瘤和血栓形成相似。
{"title":"A child with intravascular fasciitis mimicking deep vein thrombosis: a case report.","authors":"Yeşim Yiğit, Oğuzhan Erdoğan, Ayşen Türedi Yıldırım, Erdener Özer, Hüseyin Gülen","doi":"10.24953/turkjped.2023.442","DOIUrl":"10.24953/turkjped.2023.442","url":null,"abstract":"<p><strong>Background: </strong>Intravascular fasciitis (IF) is a benign, reactive, myofibroblastic proliferation that originates from the superficial or deep fascia of small / medium-sized arteries and veins.</p><p><strong>Case report: </strong>An 8-year-old male patient was admitted to a health center with the complaint of swelling in the inguinal region. Lower extremity venous Doppler ultrasonography showed deep vein thrombosis (DVT) of the femoral vein and anticoagulation with low-molecular weight heparin (LMWH) was initiated. The patient was referred to our center for follow-up. The D-dimer level was detected within normal limits. Doppler ultrasonography was repeated and showed an intraluminal expanding mass lesion with increasing vascularity, without distinct borders and LMWH was discontinued. This lesion at the sapheno-femoral junction was excised surgically and the histopathological examination revealed intravascular fasciitis.</p><p><strong>Conclusion: </strong>Clinicians should be aware that the clinical findings of IF may mimic sarcoma and thrombosis.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"66 1","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
The Turkish journal of pediatrics
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