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Local control and toxicity outcomes following consolidative radiation therapy in patients with high-risk neuroblastoma: a 20-year experience at a single center. 高危神经母细胞瘤患者接受综合放疗后的局部控制和毒性结果:单个中心的 20 年经验。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.575
Jeong Yun Jang, Jin-Hong Park, Yeon Joo Kim, Ho Joon Im, Kyung-Nam Koh, Hyery Kim, Sung Han Kang, Ha Un Kim, Seung Do Ahn

Background: Intensive multimodal treatment can improve survival in patients with high-risk neuroblastoma, and consolidative radiation therapy has contributed to local control. We examined the clinical outcomes of patients who underwent consolidative radiation therapy at our institution.

Methods: We retrospectively reviewed the records of patients with high-risk neuroblastoma who underwent consolidative radiation therapy from March 2001 to March 2021 at Asan Medical Center. Patients underwent multimodal treatment including high-dose chemotherapy, surgery, stem cell transplantation, and maintenance therapy. Radiation (median, 21.0 Gy; range, 14-36) was administered to the primary site and surrounding lymph nodes.

Results: This study included 37 patients, and the median age at diagnosis was 2.8 years (range, 1.3-10.0). Four patients exhibited local failure, and 5-year free-from locoregional failure rate was 88.7%, with a median followup period of 5.7 years. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 59.1% and 83.6%, respectively. Univariate analysis revealed that patients with neuron-specific enolase levels > 100 ng/mL had significantly worse DFS and OS (P = 0.036, 0.048), and patients with no residual disease before radiation therapy showed superior OS (P = 0.029). Furthermore, patients with 11q deletion or 17q gain exhibited poor DFS and OS, respectively (P = 0.021, 0.011). Six patients experienced grade 1 acute toxicity. Late toxicity was confirmed in children with long-term survival, predominantly hypothyroidism and hypogonadism, typically < grade 3, possibly attributed to combination treatment. Four patients experienced late toxicity ≥ grade 3 with chronic kidney disease, growth hormone abnormality, ileus, premature epiphyseal closure, and secondary tumor, and recovered by hospitalization or surgical treatment.

Conclusions: In patients with high-risk neuroblastoma, consolidative radiotherapy to the primary tumor site resulted in excellent local control and a tolerable safety profile.

背景:强化多模式治疗可提高高危神经母细胞瘤患者的生存率,而综合放疗有助于局部控制。我们研究了本院接受综合放疗患者的临床疗效:我们对牙山医疗中心 2001 年 3 月至 2021 年 3 月期间接受综合放疗的高危神经母细胞瘤患者的病历进行了回顾性分析。患者接受了多模式治疗,包括大剂量化疗、手术、干细胞移植和维持治疗。对原发部位和周围淋巴结进行放射治疗(中位数,21.0 Gy;范围,14-36):本研究共纳入 37 名患者,诊断时的中位年龄为 2.8 岁(范围为 1.3-10.0)。4例患者出现局部失败,5年无局部失败率为88.7%,中位随访时间为5.7年。5年无病生存率(DFS)和总生存率(OS)分别为59.1%和83.6%。单变量分析显示,神经元特异性烯醇化酶水平> 100 ng/mL的患者的无病生存期和总生存期明显较差(P = 0.036,0.048),而放疗前无残留疾病的患者的总生存期较好(P = 0.029)。此外,11q缺失或17q增益患者的DFS和OS分别较差(P = 0.021,0.011)。六名患者出现了一级急性毒性。晚期毒性在长期存活的儿童中得到证实,主要是甲状腺功能减退和性腺功能减退,通常<3级,可能与联合治疗有关。4名患者的晚期毒性≥3级,包括慢性肾病、生长激素异常、回肠炎、骨骺提前闭合和继发性肿瘤,通过住院或手术治疗痊愈:结论:对于高危神经母细胞瘤患者,对原发肿瘤部位进行综合放疗可取得良好的局部控制效果,且安全性可耐受。
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引用次数: 0
Response to `Rehospitalization indications of children hospitalized for COVID-19 infections and long COVID`. 对 "因COVID-19感染和长COVID住院的儿童的住院指征 "的答复。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.800
Ela Cem, Gizem Güner Özenen, Nuri Bayram, İlker Devrim
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引用次数: 0
The role of proangiogenic cytokines in predicting sepsis in febrile neutropenic children with cancer. 促血管生成细胞因子在预测发热性中性粒细胞增多症癌症患儿败血症中的作用。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2022.635
Selma Çakmakcı, Neriman Sarı, Çiğdem Sönmez, İnci Ergürhan İlhan

Background: We assessed the relationship between sepsis occurrence and the serum levels of angiopoietin (Ang-1, Ang-2), vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in pediatric patients with cancer-related febrile neutropenia.

Methods: Fifty-two children with malignant tumors who experienced 86 episodes of febrile neutropenia (FN) were examined between June 2016 and June 2018. Each FN episode was considered a separate event and the total number of FNs were recorded (86 FN episodes = FN group). The control group consisted of 21 healthy children. Ang-1, Ang-2, VEGF-A and sFlt-1 were measured at the baseline and 48th hour of each FN episode -alongside routine characterization of inflammation (C-reactive protein; white blood cell and absolute neutrophil count).

Results: Among the episodes, 29 (34.5%) developed sepsis while 57 were classified as non-complicated FN. The baseline values of patients and controls were significantly different for Ang-1, Ang-2, VEGF and sFlt-1 values (all, p < 0.05). In the subgroup with sepsis, Ang-2 values were higher than in the subgroup without sepsis (p = 0.017). In predicting sepsis, Ang-2 had 60.7% sensitivity and 66.7% specificity at the 74.6 cut-off value (AUC: 0.662 [95%CI: 0.541 - 0.783], p = 0.022), Ang-2 / Ang-1 ratio had 65.5% sensitivity and 60.0% specificity at the 0.405 cut-off value (AUC: 0.633 [95%CI: 0.513 - 0.753], p = 0.046).

Conclusions: Our results reveal that Ang-2 and Ang-2/Ang-1 were higher in the sepsis group and Ang-2 might be a biomarker to indicate the risk of sepsis in patients with FN and/or cancer.

背景:我们评估了脓毒症的发生与癌症相关发热性中性粒细胞减少症儿科患者血清中血管生成素(Ang-1、Ang-2)、血管内皮生长因子(VEGF)和可溶性fms样酪氨酸激酶-1(sFlt-1)水平之间的关系:研究人员对2016年6月至2018年6月期间发生86次发热性中性粒细胞减少症(FN)的52名恶性肿瘤患儿进行了研究。每次发热性中性粒细胞减少被视为一个独立事件,并记录了发热性中性粒细胞减少的总数(86次发热性中性粒细胞减少=发热性中性粒细胞减少组)。对照组由 21 名健康儿童组成。在每次FN发作的基线和第48小时测量Ang-1、Ang-2、VEGF-A和sFlt-1,同时对炎症进行常规定性(C反应蛋白、白细胞和绝对中性粒细胞计数):结果:在这些病例中,29 例(34.5%)发生了败血症,57 例被归类为非并发症 FN。患者和对照组的 Ang-1、Ang-2、血管内皮生长因子和 sFlt-1 的基线值有显著差异(均为 P <0.05)。在脓毒症亚组中,Ang-2 值高于无脓毒症亚组(P = 0.017)。在预测脓毒症方面,当截断值为 74.6 时,Ang-2 的灵敏度为 60.7%,特异度为 66.7%(AUC:0.662 [95%CI:0.541 - 0.783],p = 0.022);当截断值为 0.405 时,Ang-2/Ang-1 比率的灵敏度为 65.5%,特异度为 60.0%(AUC:0.633 [95%CI:0.513 - 0.753],p = 0.046):我们的研究结果表明,脓毒症组的Ang-2和Ang-2/Ang-1较高,Ang-2可能是提示FN和/或癌症患者脓毒症风险的生物标志物。
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引用次数: 0
Comparison of prematurity-related outcomes and complications in very low birth weight (VLBW) neonates fed with mother`s own milk versus donor milk: a comparative study. 用母乳喂养极低出生体重儿与用捐赠母乳喂养新生儿的早产相关结果和并发症的比较:一项比较研究。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.684
Majid Karoobi, Amir Azimi, Hamed Zarei, Maryam Saboute, Nasrin Khalessi, Zahra Vahedi

Background: When mother`s own milk (MOM) is unavailable or insufficient, donor milk (DM) from a human milk bank serves as an alternative feeding option. Our study sought to investigate and compare the outcomes and complications of very low birth weight (VLBW) preterm infants who receive MOM versus DM.

Methods: In this retrospective cohort study conducted between 2018 and 2022, we compared 70 VLBW preterm infants exclusively fed with DM to 70 randomly selected counterparts fed with MOM. Both groups began enteral feeding within 72 hours of birth. Various clinical outcomes were investigated during a three-month follow-up. The clinical outcomes were compared via independent t-tests, Mann-Whitney U, and Fisher`s exact test.

Results: The mean gestational age of the infants who were included was 29.6 ± 1.6 weeks, 84 (60%) were males, and the average birth weight was 1217 ± 151 grams. Both groups had similar baseline characteristics. The results of the study demonstrated no statistically significant differences between the groups in terms of hospital length of stay (37±16.3 days in MOM vs 40.3±16.9 days in DM group, P= 0.17), growth rate (13±4 gram/day in MOM vs 13±4 gram/day in DM group, P=0.51), growth velocity (9.8±3.0g/kg/d in MOM vs 9.5±3.2 g/kg/d in DM group), infants with in-hospital vomiting (51 cases in MOM vs 59 cases in DM group, P=0.15),vomiting frequency (1.3±1.1 times in MOM vs 1.5±1.0 times in DM group), incidence of retinopathy of prematurity (ROP) (4 cases in MOM vs 5 cases in DM group, P > 0.999) and incidence of bronchopulmonary dysplasia (BPD) (7 cases in MOM vs 6 cases in DM group, P > 0.999).

Conclusion: Our study findings indicate that the utilization of DM didn`t have a substantial negative impact on infants` outcomes nor any complications in comparison with MOM.

背景:当母奶(MOM)不可用或不足时,来自母乳库的捐赠奶(DM)可作为替代喂养选择。我们的研究旨在调查和比较极低出生体重(VLBW)早产儿接受 MOM 与 DM 的结果和并发症:在这项于 2018 年至 2022 年进行的回顾性队列研究中,我们比较了 70 名完全使用 DM 喂养的 VLBW 早产儿和 70 名随机挑选的使用 MOM 喂养的同类早产儿。两组婴儿均在出生后 72 小时内开始肠内喂养。在三个月的随访期间,对各种临床结果进行了调查。临床结果通过独立t检验、曼-惠特尼U检验和费雪精确检验进行比较:结果:纳入研究的婴儿的平均胎龄为 29.6 ± 1.6 周,其中 84 名(60%)为男性,平均出生体重为 1217 ± 151 克。两组婴儿的基线特征相似。研究结果显示,两组在住院时间(MOM 组为 37±16.3 天 vs DM 组为 40.3±16.9 天,P= 0.17)、生长速度(MOM 组为 13±4 克/天 vs DM 组为 13±4 克/天,P=0.51)、生长速度(MOM 组为 9.8±3.0 克/千克/天 vs DM 组为 9.5±3.2克/千克/天)、院内呕吐婴儿(MOM组51例 vs DM组59例,P=0.15)、呕吐次数(MOM组1.3±1.1次 vs DM组1.5±1.0次)、早产儿视网膜病变(ROP)发生率(MOM组4例 vs DM组5例,P>0.999)和支气管肺发育不良(BPD)发生率(MOM组7例 vs DM组6例,P>0.999):我们的研究结果表明,与MOM相比,使用DM对婴儿的预后和任何并发症都没有实质性的负面影响。
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引用次数: 0
The impact of the prolonged COVID-19 pandemic on adolescents with eating disorders: a follow-up study from Türkiye. COVID-19大流行对患有饮食失调症的青少年的影响:土耳其的一项后续研究。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.701
Şeyma Erdem Torun, Sinem Akgül, Melis Pehlivantürk Kızılkan, Kevser Nalbant, Nuray Kanbur, Devrim Akdemir, Burcu Ersöz Alan, Zeynep Tüzün, Orhan Derman

Background: At the onset of the pandemic, we conducted a study on adolescents with eating disorders (EDs) and found no deterioration in ED symptoms. The objective of this subsequent study was to conduct a follow-up evaluation of the same cohort and investigate the consequences of the prolonged pandemic.

Methods: This longitudinal study was conducted one year after the first study between May 2021 and June 2021 with 37 adolescents aged 12-18 years (pre-existing EDs). The reassessment included an evaluation of sociodemographic and clinical characteristics, the impact of pandemic-related restrictions on ED behaviors, well-being, and quality of life. All the participants underwent a re-administration of the ED examination questionnaire (EDE-Q), Beck Depression Inventory, the State Anxiety Inventory for Children, and the Maudsley Obsessive Compulsive Inventory.

Results: No significant difference was observed in the EDE-Q scores or the ED examination questionnaire scores between the initial (T1) and subsequent (T2) study. The ED-related quality of life was seen to have slightly improved in the later stage. While depression (T1: 18, T2: 15, p=0.883) and obsession scores (T1: 11, T2: 14, p: 0.536) showed no disparity between the studies, anxiety scores (T1: 38, T2: 43, p:0.011) exhibited a significant increase.

Conclusions: Consistent with the early phase, no exacerbation of ED symptoms in adolescents was observed during the later stages of the pandemic. Close clinical monitoring during the pandemic might have been protective against the deteriorating effects of the pandemic. During social isolation, it is important to monitor adolescents with EDs continously for depression and anxiety.

背景:大流行开始时,我们对患有饮食失调症(ED)的青少年进行了一项研究,结果发现ED症状没有恶化。后续研究的目的是对同一人群进行跟踪评估,并调查大流行持续时间过长的后果:这项纵向研究是在首次研究一年后的 2021 年 5 月至 2021 年 6 月期间进行的,研究对象是 37 名 12-18 岁的青少年(之前已患有 ED)。重新评估包括评估社会人口学和临床特征、与大流行相关的限制对 ED 行为的影响、幸福感和生活质量。所有参与者都重新接受了 ED 检查问卷(EDE-Q)、贝克抑郁量表、儿童焦虑状态量表和莫兹利强迫症量表的测试:在初次研究(T1)和后续研究(T2)之间,EDE-Q 评分和 ED 检查问卷评分均无明显差异。与 ED 相关的生活质量在后期研究中略有改善。虽然抑郁(T1:18,T2:15,P=0.883)和强迫症评分(T1:11,T2:14,P:0.536)在研究之间没有差异,但焦虑评分(T1:38,T2:43,P:0.011)却有显著增加:与早期阶段一致,在大流行的后期阶段没有观察到青少年的 ED 症状加重。在大流行期间进行严密的临床监测可能会对大流行的恶化起到保护作用。在与世隔绝期间,对患有 ED 的青少年进行持续的抑郁和焦虑监测非常重要。
{"title":"The impact of the prolonged COVID-19 pandemic on adolescents with eating disorders: a follow-up study from Türkiye.","authors":"Şeyma Erdem Torun, Sinem Akgül, Melis Pehlivantürk Kızılkan, Kevser Nalbant, Nuray Kanbur, Devrim Akdemir, Burcu Ersöz Alan, Zeynep Tüzün, Orhan Derman","doi":"10.24953/turkjped.2023.701","DOIUrl":"10.24953/turkjped.2023.701","url":null,"abstract":"<p><strong>Background: </strong>At the onset of the pandemic, we conducted a study on adolescents with eating disorders (EDs) and found no deterioration in ED symptoms. The objective of this subsequent study was to conduct a follow-up evaluation of the same cohort and investigate the consequences of the prolonged pandemic.</p><p><strong>Methods: </strong>This longitudinal study was conducted one year after the first study between May 2021 and June 2021 with 37 adolescents aged 12-18 years (pre-existing EDs). The reassessment included an evaluation of sociodemographic and clinical characteristics, the impact of pandemic-related restrictions on ED behaviors, well-being, and quality of life. All the participants underwent a re-administration of the ED examination questionnaire (EDE-Q), Beck Depression Inventory, the State Anxiety Inventory for Children, and the Maudsley Obsessive Compulsive Inventory.</p><p><strong>Results: </strong>No significant difference was observed in the EDE-Q scores or the ED examination questionnaire scores between the initial (T1) and subsequent (T2) study. The ED-related quality of life was seen to have slightly improved in the later stage. While depression (T1: 18, T2: 15, p=0.883) and obsession scores (T1: 11, T2: 14, p: 0.536) showed no disparity between the studies, anxiety scores (T1: 38, T2: 43, p:0.011) exhibited a significant increase.</p><p><strong>Conclusions: </strong>Consistent with the early phase, no exacerbation of ED symptoms in adolescents was observed during the later stages of the pandemic. Close clinical monitoring during the pandemic might have been protective against the deteriorating effects of the pandemic. During social isolation, it is important to monitor adolescents with EDs continously for depression and anxiety.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"66 1","pages":"42-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208796","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
Anxiety, depression, sleep disorders and quality of life in parents of children with first unprovoked seizure and epilepsy. 首次无诱因癫痫发作和癫痫患儿父母的焦虑、抑郁、睡眠障碍和生活质量。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.6
Bilge Özgör, Neslihan Cansel

Background: Parents of a child with neurological problems such as seizures and epilepsy experience significant mental distress. Little is known about the mental state of parents in such a stressful situation. This study aims to determine the prevalence of self-reported depression, anxiety, sleep disorders, and quality of life in parents of children with epilepsy and first unprovoked seizure.

Methods: This cross-sectional study was conducted among the parents of children diagnosed with first unprovoked seizure and epilepsy admitted to the Pediatric Neurology Department, Outpatient Unit of İnönü University Medical Faculty Hospital. Participants filled out a questionnaire investigating demographic variables, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36- Item Short-Form Health Survey (SF-36).

Results: 113 parents participated in the study. Depression was found in 7%, anxiety in 14%, and sleep quality disorder in 33.3% of parents of children diagnosed with epilepsy on the basis of moderate or higher severity, while depression was found in 8.9%, anxiety in 14.3%, and sleep disorder in 21.4% of parents of children diagnosed with first unprovoked seizure. There was no statistically significant difference between the groups. Mothers were at higher risk for loss of physical function and social functionality. There was a positive correlation between BAI, BDI, and PSQI scores. Quality of life sub-dimension measured by SF-36 was associated with different levels of depression, anxiety, and sleep quality.

Conclusion: Addressing parental psychiatric problems by professionals involved in the treatment of children with a history of seizures may have the potential to provide further support for the family and the care of patients.

背景:有神经系统问题(如癫痫发作和癫痫)的儿童的父母会经历巨大的精神压力。人们对处于这种紧张状态下的父母的精神状态知之甚少。本研究旨在确定癫痫和首次无诱因癫痫发作患儿家长自我报告的抑郁、焦虑、睡眠障碍和生活质量的患病率:这项横断面研究的对象是伊农大学医学院附属医院门诊部小儿神经科确诊为首次无诱因癫痫发作和癫痫患儿的家长。参与者填写了调查人口统计学变量、贝克焦虑量表(BAI)、贝克抑郁量表(BDI)、匹兹堡睡眠质量指数(PSQI)和 36 项短式健康调查(SF-36)的问卷:113 名家长参与了研究。在被诊断为中度或更严重癫痫的儿童家长中,7%的家长患有抑郁症,14%的家长患有焦虑症,33.3%的家长患有睡眠质量障碍;而在被诊断为首次无诱因癫痫发作的儿童家长中,8.9%的家长患有抑郁症,14.3%的家长患有焦虑症,21.4%的家长患有睡眠障碍。各组之间在统计学上没有明显差异。母亲丧失身体功能和社会功能的风险较高。BAI、BDI 和 PSQI 分数之间呈正相关。用 SF-36 测量的生活质量子维度与不同程度的抑郁、焦虑和睡眠质量相关:参与治疗有癫痫发作史的儿童的专业人员解决父母的精神问题,有可能为家庭和患者护理提供进一步的支持。
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引用次数: 0
Early neonatal outcomes in infants of mothers with organ transplantation under immunosuppressive treatment. 接受免疫抑制治疗的器官移植母亲所生婴儿的早期新生儿预后。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.748
Kıymet Çelik, Sema Arayıcı, Nurten Özkan Zarif, Zeynep Kıhtır, Hakan Ongun, Bülent Aydınlı

Background: This study aimed to examine early clinical and laboratory findings in infants born to mothers who had organ transplants and received immunosuppressive treatment.

Methods: Between 2016 and 2023, the study examined infants of mothers who underwent organ transplantation and were receiving immunosuppressive treatment, and followed at the Department of Neonatology at Akdeniz University. Demographic, clinical, and laboratory characteristics of mothers and infants were recorded. On the first day of life, complete blood count values were examined, as well as potassium levels on the first, third, and seventh days, and creatinine levels on the third and seventh days. The tacrolimus blood level was calculated by taking the average of the tacrolimus blood values of the mother measured during the pregnancy. The infants were evaluated for any potential morbidities caused by intrauterine immunosuppressive drug exposure.

Results: The study included 21 mothers (some with multiple pregnancies) and 27 infants. According to the findings of this study, 74% of these infants were born premature, 67% had low birth weight, and all were delivered via cesarean section. Prematurity was associated with the morbidities found in the infants. In the early period, lymphopenia was detected in 37%, neutropenia in 25.9%, thrombocytopenia in 11.1%, hyperkalemia in 18.5%, and creatinine elevation in 7.4%, all of which returned to normal within a few days. There was no significant relationship between maternal tacrolimus blood levels and infant potassium and creatinine levels.

Conclusion: Apart from an increased risk of prematurity, low birth weight, and cesarean delivery, no effects were observed in these infants during the early period. However, long-term follow-up is necessary to monitor for any potential morbidities.

背景:本研究旨在检测母亲接受器官移植和免疫抑制治疗的婴儿的早期临床和实验室结果:本研究旨在检查接受过器官移植和免疫抑制治疗的母亲所生婴儿的早期临床和实验室结果:方法:2016 年至 2023 年期间,研究人员在阿克登尼兹大学新生儿科对接受器官移植并接受免疫抑制治疗的母亲所生的婴儿进行了随访。研究记录了母亲和婴儿的人口统计学特征、临床特征和实验室特征。在婴儿出生后的第一天,检查了全血细胞计数值,以及第一、第三和第七天的血钾水平,第三和第七天的血肌酐水平。他克莫司血药浓度的计算方法是取母亲在怀孕期间测量的他克莫司血药浓度的平均值。对婴儿进行了评估,以确定宫内免疫抑制药物接触是否可能导致发病:这项研究包括 21 名母亲(其中一些是多胎妊娠)和 27 名婴儿。研究结果显示,74%的婴儿为早产儿,67%的婴儿出生体重不足,且所有婴儿均为剖腹产。早产与婴儿的发病率有关。在早期,37%的婴儿出现淋巴细胞减少症,25.9%的婴儿出现中性粒细胞减少症,11.1%的婴儿出现血小板减少症,18.5%的婴儿出现高钾血症,7.4%的婴儿出现肌酐升高,但所有这些症状都在几天内恢复正常。母体他克莫司血药浓度与婴儿血钾和肌酐水平之间没有明显关系:结论:除了早产、低出生体重和剖宫产的风险增加外,这些婴儿在用药初期没有受到任何影响。然而,有必要进行长期随访,以监测任何潜在的发病率。
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引用次数: 0
Effect of intravenous lipid therapy in critically ill pediatric patients with calcium channel blocker toxicity. 静脉注射脂质疗法对钙通道阻滞剂中毒的儿科重症患者的影响。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.543
Sinan Yavuz, Ali Avcı, Rabia Gündoğan Serin, Mustafa Mesut Kaya, Dilfuza Ağalıoğlu

Background: Overdose with calcium-channel blockers (CCBs) still maintain their importance with a high lethality rate after exposure. We report the intravenous lipid emulsion therapy (ILE) therapy in our CCB overdose patients.

Methods: We retrospectively analyzed the records of 6 patients with CCB intoxication from Batman Training and Research Hospital PICU between March 2021 and September 2022. Patients aged 0-18 years who received ILE treatment for CCB poisoning were included.

Results: All six patients ingested CCB with the intention of committing suicide and were followed up in the pediatric intensive care unit (PICU). All patients received ILE therapy due to hemodynamic instability despite intravenous fluid boluses, calcium, glucagon, insulin-dextrose, and vasoactive agents. Vasoactive-Inotropic Score (VIS) decreased after ILE treatment. All patients were transferred from the PICU after recovery.

Conclusions: ILE therapy should be kept in mind as a salvage therapy in hemodynamically unstable CCB poisoning cases that do not respond to initial and advanced options.

背景:钙通道阻滞剂(CCB)用药过量仍具有重要意义,暴露后致死率很高。我们报告了钙离子通道阻滞剂过量患者的静脉脂质乳剂疗法(ILE):我们回顾性分析了 2021 年 3 月至 2022 年 9 月期间蝙蝠侠训练研究医院 PICU 的 6 例氯苯中毒患者的病历。方法:我们回顾分析了 2021 年 3 月至 2022 年 9 月期间蝙蝠侠培训研究医院 PICU 的 6 名氯苯中毒患者的病历,其中包括因氯苯中毒接受 ILE 治疗的 0-18 岁患者:结果:所有六名患者均以自杀为目的摄入氯苯,并在儿科重症监护室(PICU)接受随访。所有患者均因血流动力学不稳定而接受了 ILE 治疗,尽管静脉注射了液体、钙剂、胰高血糖素、胰岛素-葡萄糖和血管活性药物。ILE 治疗后,血管活性-肌张力评分(VIS)下降。所有患者在康复后都转出了重症监护病房:结论:ILE疗法作为一种挽救疗法,在血流动力学不稳定的氯苯中毒病例中应牢记这一点。
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引用次数: 0
Camptodactyly-arthropathy-coxa vara-pericarditis syndrome and an unusual association with mitral stenosis. 驼背-关节病-心包炎综合征以及与二尖瓣狭窄的不寻常关联。
Pub Date : 2024-01-01 DOI: 10.24953/turkjped.2023.647
Duygu Şimşekli, Canan Ayabakan, Ayla Oktay, Ahmet Arnaz, Vusal Mahmudov, Yusuf Kenan Yalçınbaş

Background: Campotodactyly-artrhropathy-coxa vara-pericarditis (CACP) syndrome is a very rare autosomal recessive genetic disorder. It is characterized by flexion contracture of the fifth finger (camptodactyly); noninflammatory arthropathy; decreased angle between the shaft and the head of the femur (coxa vara) and pericarditis. Its association with mitral stenosis has not yet been reported. Hereby we report this unique association with CACP syndrome.

Case: An eleven-year-old girl presented with non-productive cough, dyspnea, and orthopnea. She was diagnosed CACP syndrome at the age of seven and a biallelic frameshift mutation in the PRG4 gene was determined. The physical examination revealed pectus excavatum, camptodactyly, genu valgum, tachypnea and orthopnea. The functional capacity was NYHA III-IV. She had 2/6 soft pansystolic murmur at 4th left intercostal space and a rumbling diastolic murmur at apex. Echocardiography revealed an enlarged left atrium, severe stenotic mitral valve with a mean diastolic transmitral gradient of 22.5 mmHg, mild mitral regurgitation and mild apical pericardial effusion. The patient had mitral comissurotomy and partial pericardiectomy operation. Her post-operative transmitral gradient decreased to 6.9 mmHg and the pulmonary pressure was 30 mmHg. Her functional capacity increased to NYHA I-II.

Conclusions: The main defect is the proteoglycan 4 protein which acts like a lubricant in articular and visceral surfaces. Therefore, the leading clinical feature is arthropathy. Cardiac involvement other than clinically mild pericarditis is not usually expected. Three types of proteoglycans (decorin, biglycan, and versican) are present in the mitral valve. This could be the reason of mitral valve involvement in rare cases as like ours. It is important that these patients undergo echocardiographic examination regularly.

背景:外翻-肝病-髋臼-心包炎(CACP)综合征是一种非常罕见的常染色体隐性遗传疾病。其特征是五指屈曲挛缩(campptodactyly)、非炎症性关节病、股骨柄与股骨头之间的角度减小(coxa vara)和心包炎。该病与二尖瓣狭窄的关系尚未见报道。在此,我们报告了这一与 CACP 综合征有关的独特病例:病例:一名 11 岁的女孩因无痰咳嗽、呼吸困难和呼吸困难而就诊。她在七岁时被诊断为 CACP 综合征,并确定 PRG4 基因存在双倍体框移位突变。体格检查显示她有乳突、驼背、膝外翻、呼吸急促和呼吸困难。她的机能为 NYHA III-IV。她在左侧第四肋间隙处有2/6的软性泛收缩期杂音,心尖处有隆隆的舒张期杂音。超声心动图显示左心房增大,二尖瓣严重狭窄,舒张期平均传导阶差为22.5毫米汞柱,二尖瓣轻度反流,心尖部轻度心包积液。患者接受了二尖瓣裂切除术和部分心包切除术。术后她的二尖瓣跨瓣梯度降至 6.9 mmHg,肺动脉压力为 30 mmHg。结论:主要缺陷是蛋白多糖 4 蛋白,它在关节和内脏表面起润滑作用。因此,主要的临床特征是关节病。除了临床上轻微的心包炎外,通常不会累及心脏。二尖瓣中存在三种蛋白聚糖(decolin、biglycan 和 versican)。这可能是像我们这样的罕见病例二尖瓣受累的原因。这些患者必须定期接受超声心动图检查。
{"title":"Camptodactyly-arthropathy-coxa vara-pericarditis syndrome and an unusual association with mitral stenosis.","authors":"Duygu Şimşekli, Canan Ayabakan, Ayla Oktay, Ahmet Arnaz, Vusal Mahmudov, Yusuf Kenan Yalçınbaş","doi":"10.24953/turkjped.2023.647","DOIUrl":"10.24953/turkjped.2023.647","url":null,"abstract":"<p><strong>Background: </strong>Campotodactyly-artrhropathy-coxa vara-pericarditis (CACP) syndrome is a very rare autosomal recessive genetic disorder. It is characterized by flexion contracture of the fifth finger (camptodactyly); noninflammatory arthropathy; decreased angle between the shaft and the head of the femur (coxa vara) and pericarditis. Its association with mitral stenosis has not yet been reported. Hereby we report this unique association with CACP syndrome.</p><p><strong>Case: </strong>An eleven-year-old girl presented with non-productive cough, dyspnea, and orthopnea. She was diagnosed CACP syndrome at the age of seven and a biallelic frameshift mutation in the PRG4 gene was determined. The physical examination revealed pectus excavatum, camptodactyly, genu valgum, tachypnea and orthopnea. The functional capacity was NYHA III-IV. She had 2/6 soft pansystolic murmur at 4th left intercostal space and a rumbling diastolic murmur at apex. Echocardiography revealed an enlarged left atrium, severe stenotic mitral valve with a mean diastolic transmitral gradient of 22.5 mmHg, mild mitral regurgitation and mild apical pericardial effusion. The patient had mitral comissurotomy and partial pericardiectomy operation. Her post-operative transmitral gradient decreased to 6.9 mmHg and the pulmonary pressure was 30 mmHg. Her functional capacity increased to NYHA I-II.</p><p><strong>Conclusions: </strong>The main defect is the proteoglycan 4 protein which acts like a lubricant in articular and visceral surfaces. Therefore, the leading clinical feature is arthropathy. Cardiac involvement other than clinically mild pericarditis is not usually expected. Three types of proteoglycans (decorin, biglycan, and versican) are present in the mitral valve. This could be the reason of mitral valve involvement in rare cases as like ours. It is important that these patients undergo echocardiographic examination regularly.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"66 1","pages":"134-138"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208805","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
Investigation of adolescents and their mothers in terms of nomophobia. 青少年及其母亲的诺模恐惧症调查。
Pub Date : 2023-01-01 DOI: 10.24953/turkjped.2023.350
Yusuf Selman Çelik, Burcu Ersöz Alan

Background: Nomophobia (NoMP) is the fear of being unable to interact with others via mobile phones and is a current topic in adolescents` mental health. The purpose of this study was to investigate the association between NoMP in adolescents and their mothers` level of NoMP.

Methods: The levels of depression, anxiety, attention deficit/hyperactivity-impulsivity symptoms, NoMP, and perceived parental emotional availability were examined.

Results: One hundred fifty-five adolescents (60% girls) were included in the study with their mothers. Ninetythree (60%) adolescents (67.7% girls) and 64 (41.3%) mothers were classified as nomophobic. There was a positive correlation between the NoMP levels of adolescents and their mothers. Nomophobic girls perceived less paternal support. All psychopathologic symptoms were higher in the nomophobic mothers. There was no difference between nomophobic and non-nomophobic adolescents in terms of maternal psychopathologies.

Conclusions: We suggest that parental effects should be investigated during the assessment of NoMP, especially in adolescent girls. The phone usage habits of mothers and their relationship with their adolescent children were closely associated with adolescent NoMP.

背景:Nomophobia(NoMP)是指对无法通过手机与他人互动的恐惧,是青少年心理健康领域的一个热门话题。本研究的目的是调查青少年的NoMP与其母亲的NoMP水平之间的关系。方法:检测抑郁、焦虑、注意力缺陷/多动冲动症状、NoMP和感知父母情绪可用性的水平。结果:155名青少年(60%为女孩)与母亲一起参与了这项研究。有93名(60%)青少年(67.7%为女孩)和64名(41.3%)母亲被归类为无恐惧症。青少年的NoMP水平与其母亲呈正相关。厌恶游牧的女孩认为父亲的支持更少。无恐惧症母亲的所有精神病理症状均较高。在母亲精神病理学方面,有无恐惧症的青少年和无无恐惧症青少年之间没有差异。结论:我们建议在评估NoMP时应调查父母的影响,尤其是对青春期女孩的影响。母亲的电话使用习惯及其与青春期子女的关系与青少年NoMP密切相关。
{"title":"Investigation of adolescents and their mothers in terms of nomophobia.","authors":"Yusuf Selman Çelik,&nbsp;Burcu Ersöz Alan","doi":"10.24953/turkjped.2023.350","DOIUrl":"10.24953/turkjped.2023.350","url":null,"abstract":"<p><strong>Background: </strong>Nomophobia (NoMP) is the fear of being unable to interact with others via mobile phones and is a current topic in adolescents` mental health. The purpose of this study was to investigate the association between NoMP in adolescents and their mothers` level of NoMP.</p><p><strong>Methods: </strong>The levels of depression, anxiety, attention deficit/hyperactivity-impulsivity symptoms, NoMP, and perceived parental emotional availability were examined.</p><p><strong>Results: </strong>One hundred fifty-five adolescents (60% girls) were included in the study with their mothers. Ninetythree (60%) adolescents (67.7% girls) and 64 (41.3%) mothers were classified as nomophobic. There was a positive correlation between the NoMP levels of adolescents and their mothers. Nomophobic girls perceived less paternal support. All psychopathologic symptoms were higher in the nomophobic mothers. There was no difference between nomophobic and non-nomophobic adolescents in terms of maternal psychopathologies.</p><p><strong>Conclusions: </strong>We suggest that parental effects should be investigated during the assessment of NoMP, especially in adolescent girls. The phone usage habits of mothers and their relationship with their adolescent children were closely associated with adolescent NoMP.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"65 5","pages":"822-831"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49687320","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
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The Turkish journal of pediatrics
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