Celio-mesenteric trunk (CMT) is a rare vascular variation of the ventral branches of the abdominal aorta that supply blood to the mesentery and the gut. This rare variation is seen in 2/100.000 population. The presence of this anomaly is associated with an increased risk of mesenteric ischemia in the case of proximal occlusion. Median arcuate ligament (MAL) syndrome is a controversial entity characterized by compression of the celiac axis by MAL causing post-prandial pain. We report the fourth case of MAL compression syndrome involving a CMT in the world.
腹腔肠管干（CMT）是腹主动脉腹侧分支的一种罕见血管变异，它向肠系膜和肠道供应血液。这种罕见变异的发病率仅为 2/100,000。出现这种异常与近端闭塞时肠系膜缺血的风险增加有关。正中弓状韧带（MAL）综合征是一种有争议的疾病，其特点是腹腔轴受到 MAL 的压迫，导致餐后疼痛。我们报告了世界上第四例涉及 CMT 的 MAL 压迫综合征。
{"title":"Median Arcuate Ligament Syndrome Involving a Celio-Mesenteric Trunk-a Lesson Learnt","authors":"Uddalok Das","doi":"10.4274/jpea.2024.296","DOIUrl":"https://doi.org/10.4274/jpea.2024.296","url":null,"abstract":"Celio-mesenteric trunk (CMT) is a rare vascular variation of the ventral branches of the abdominal aorta that supply blood to the mesentery and the gut. This rare variation is seen in 2/100.000 population. The presence of this anomaly is associated with an increased risk of mesenteric ischemia in the case of proximal occlusion. Median arcuate ligament (MAL) syndrome is a controversial entity characterized by compression of the celiac axis by MAL causing post-prandial pain. We report the fourth case of MAL compression syndrome involving a CMT in the world.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":" 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141825424","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}
Şefika Akyol, Şerife Şebnem Önen Göktepe, Ayşegül Akgün, Can Balkan
Improving bone health and preventing osteoporosis is an essential approach for hemophilia patients. Regarding precautions, the treatment model may affect bone health. To detect the effect of a treatment model (prophylaxis/on-demand treatment) on bone metabolism in patients with severe hemophilia A was the primary aim of this study. The biochemical markers of bone metabolism and bone mineral density were obtained from the patients enrolled in the study. No statistically significant differences were found between the groups due to the limitations of the prophylaxis group, such as adaptation problems, personal differences, and type of prophylaxis.
改善骨骼健康和预防骨质疏松症是血友病患者的基本方法。关于预防措施，治疗模式可能会影响骨骼健康。本研究的主要目的是检测治疗模式（预防/按需治疗）对重症血友病 A 患者骨代谢的影响。本研究从参与研究的患者身上获得了骨代谢和骨矿物质密度的生化指标。由于预防组存在适应问题、个人差异和预防类型等局限性，因此两组之间没有发现明显的统计学差异。
{"title":"Effects of Treatment Model on Bone Metabolism in Patients with Severe Hemophilia A","authors":"Şefika Akyol, Şerife Şebnem Önen Göktepe, Ayşegül Akgün, Can Balkan","doi":"10.4274/jpea.2024.321","DOIUrl":"https://doi.org/10.4274/jpea.2024.321","url":null,"abstract":"Improving bone health and preventing osteoporosis is an essential approach for hemophilia patients. Regarding precautions, the treatment model may affect bone health. To detect the effect of a treatment model (prophylaxis/on-demand treatment) on bone metabolism in patients with severe hemophilia A was the primary aim of this study. The biochemical markers of bone metabolism and bone mineral density were obtained from the patients enrolled in the study. No statistically significant differences were found between the groups due to the limitations of the prophylaxis group, such as adaptation problems, personal differences, and type of prophylaxis.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"50 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663287","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}
The most common cause of non-inflammatory recurrent musculoskeletal pain in children is growing pains. History and physical examination are often sufficient to diagnose these patients. Since the exact etiology is not known, different treatments can be applied. The effect of vitamin D levels on children with growing pains was investigated. Clinical and laboratory findings of 138 pediatric patients with growing pain and 30 healthy control subjects were examined and then the changes in pain scores of children and their families with follow-up and treatment were evaluated. The pain was most commonly seen in the form of lower extremity pain at night and in girls. Although growing pains can be treated with nonpharmacological methods, there were also patients who required pharmacological treatment. Vitamin D deficiency was observed in children with growing pain. Vitamin D treatment was given to 46 patients with vitamin D deficiency. Pain scores made by both themselves and their families decreased in 91.4% of the patients who came for control. After the use of vitamin D in children with growing pains, the mean pain score reported by the children decreased from 7.26±1.757 to 2.46±2.38. The mean pain score reported by families about their children decreased from 7.56±1.97 to 2.51±2.53 after vitamin D supplementation. Although most of the time growing pain is a self-limiting clinical picture, vitamin D supplementation may be necessary after a differential diagnosis was made because of the high level of anxiety in the families of children who do not respond to non-pharmacological approaches.
儿童非炎症性复发性肌肉骨骼疼痛最常见的原因是生长痛。病史和体格检查通常足以诊断这些患者。由于确切的病因不明，因此可以采用不同的治疗方法。本研究调查了维生素 D 水平对生长痛儿童的影响。研究人员对 138 名患有生长痛的儿科患者和 30 名健康对照者进行了临床和实验室检查，然后评估了儿童及其家人在随访和治疗过程中疼痛评分的变化。生长痛最常见的形式是夜间下肢疼痛，且多发于女孩。虽然生长痛可以通过非药物方法治疗，但也有患者需要药物治疗。在患有生长痛的儿童中发现了维生素 D 缺乏症。46 名维生素 D 缺乏症患者接受了维生素 D 治疗。在接受治疗的患者中，91.4%的患者自己和家人对疼痛的评分有所下降。对生长痛患儿使用维生素 D 后，患儿的平均疼痛评分从（7.26±1.757）分降至（2.46±2.38）分。补充维生素 D 后，家人对孩子的平均疼痛评分从 7.56±1.97 降至 2.51±2.53。虽然大多数情况下生长痛是一种自限性临床表现，但由于对非药物治疗无效的患儿家属焦虑程度较高，因此在做出鉴别诊断后可能有必要补充维生素 D。
{"title":"Vitamin D Levels in Growth-Paining Children","authors":"Ömer Günbey, M. Gürgöze, Fatma Betül Günbey","doi":"10.4274/jpea.2024.300","DOIUrl":"https://doi.org/10.4274/jpea.2024.300","url":null,"abstract":"The most common cause of non-inflammatory recurrent musculoskeletal pain in children is growing pains. History and physical examination are often sufficient to diagnose these patients. Since the exact etiology is not known, different treatments can be applied. The effect of vitamin D levels on children with growing pains was investigated. Clinical and laboratory findings of 138 pediatric patients with growing pain and 30 healthy control subjects were examined and then the changes in pain scores of children and their families with follow-up and treatment were evaluated. The pain was most commonly seen in the form of lower extremity pain at night and in girls. Although growing pains can be treated with nonpharmacological methods, there were also patients who required pharmacological treatment. Vitamin D deficiency was observed in children with growing pain. Vitamin D treatment was given to 46 patients with vitamin D deficiency. Pain scores made by both themselves and their families decreased in 91.4% of the patients who came for control. After the use of vitamin D in children with growing pains, the mean pain score reported by the children decreased from 7.26±1.757 to 2.46±2.38. The mean pain score reported by families about their children decreased from 7.56±1.97 to 2.51±2.53 after vitamin D supplementation. Although most of the time growing pain is a self-limiting clinical picture, vitamin D supplementation may be necessary after a differential diagnosis was made because of the high level of anxiety in the families of children who do not respond to non-pharmacological approaches.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679524","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}
S. Vajpayee, A. Goyal, Yogesh Yadav, Ruchi Agarwal
To study the clinical profile and laboratory characteristics and treatment of children with Wilson’s disease (WD). The current study was done at Department of pediatrics, Sir Padampat Institute of Neonatology and Pediatric Health, Sawai Man Singh Medical College, Jaipur. It was an observational study and institution ethics committee approved the study. Patients visiting the outpatient department or admitting in wards with clinical presentation suggestive of WD were enrolled in the study after obtaining a valid informed written consent. Patients subjected to detailed clinical history and physical examination. All patients subjected to routine blood count, biochemistry including liver function tests and specific laboratory investigations. They underwent ophthalmological examination. Ultrasonography abdomen and liver biopsy performed in enrolled patients. Magnetic resonance imaging brain carried out in patients with neurological WD. Ferenci score was calculated for each of the patients. Total 50 patients were included in the study. Mean age at the time of diagnosis was 9.4 years with delay of 11 months after onset of symptoms. Male is to female ratio was 2/1. Hepatic manifestation were seen in 76% patients and 24% patients presented with neurological disease. Kayser-Fleischer ring was seen in 44% patients with hepatic disease and 83% patients with neurological disease. Twenty-four hour urinary copper was more than 2 time of upper limit of normal in all patients. Fifty-four percent patients showed improvement with chelation therapy and 9 patients died during the study period. WD in children has varied clinical manifestation and early diagnosis is necessary for good prognosis. It requires wide range of tests as genetic testing is not easily available. Acute liver failure has high mortality. Early chelation therapy reverses the clinical and biochemical abnormalities.
{"title":"Clinical Profile, Laboratory Characteristics and Treatment of Wilson’s Disease in Children from Western India","authors":"S. Vajpayee, A. Goyal, Yogesh Yadav, Ruchi Agarwal","doi":"10.4274/jpea.2024.265","DOIUrl":"https://doi.org/10.4274/jpea.2024.265","url":null,"abstract":"To study the clinical profile and laboratory characteristics and treatment of children with Wilson’s disease (WD). The current study was done at Department of pediatrics, Sir Padampat Institute of Neonatology and Pediatric Health, Sawai Man Singh Medical College, Jaipur. It was an observational study and institution ethics committee approved the study. Patients visiting the outpatient department or admitting in wards with clinical presentation suggestive of WD were enrolled in the study after obtaining a valid informed written consent. Patients subjected to detailed clinical history and physical examination. All patients subjected to routine blood count, biochemistry including liver function tests and specific laboratory investigations. They underwent ophthalmological examination. Ultrasonography abdomen and liver biopsy performed in enrolled patients. Magnetic resonance imaging brain carried out in patients with neurological WD. Ferenci score was calculated for each of the patients. Total 50 patients were included in the study. Mean age at the time of diagnosis was 9.4 years with delay of 11 months after onset of symptoms. Male is to female ratio was 2/1. Hepatic manifestation were seen in 76% patients and 24% patients presented with neurological disease. Kayser-Fleischer ring was seen in 44% patients with hepatic disease and 83% patients with neurological disease. Twenty-four hour urinary copper was more than 2 time of upper limit of normal in all patients. Fifty-four percent patients showed improvement with chelation therapy and 9 patients died during the study period. WD in children has varied clinical manifestation and early diagnosis is necessary for good prognosis. It requires wide range of tests as genetic testing is not easily available. Acute liver failure has high mortality. Early chelation therapy reverses the clinical and biochemical abnormalities.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"31 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711978","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}
Mohamad Abdelkhalik, Myriam Boueri, Leah Nasr, Christina Khater
Virtual reality (VR) technology has received considerable interest in the healthcare field, particularly in pediatric oncology. Thepurpose of this study was to examine the existing and future applications of VR in reducing the discomfort associated withpediatric oncology procedures such as bone marrow biopsy, bone marrow aspirate, and lumbar puncture. A comprehensive search was conducted across numerous databases from 2005 to 2023, embracing several study designs to provide a strong evidence foundation. Using diversion and relaxation strategies, VR can help pediatric cancer patients cope with the emotional issues they confront during operations. VR has shown significant potential for lowering pain and anxiety during several pediatric medical procedures. Patient feedback focused on VR’s empowering and anxiety-reducing benefits, while healthcare staff reported increased patient participation and procedural efficiency. VR implementation challenges include the cost of specialized technology, the need for specific virtual settings, and the need for training healthcare workers. VR shows promise in improving the pediatric cancer experience, but more study and cooperation are required to realize its full potential.
{"title":"A Narrative Review: Transforming Pediatric Oncology Care Through Virtual Reality - Pain Management and Enhanced Patient Experience","authors":"Mohamad Abdelkhalik, Myriam Boueri, Leah Nasr, Christina Khater","doi":"10.4274/jpea.2024.271","DOIUrl":"https://doi.org/10.4274/jpea.2024.271","url":null,"abstract":"Virtual reality (VR) technology has received considerable interest in the healthcare field, particularly in pediatric oncology. Thepurpose of this study was to examine the existing and future applications of VR in reducing the discomfort associated withpediatric oncology procedures such as bone marrow biopsy, bone marrow aspirate, and lumbar puncture. A comprehensive search was conducted across numerous databases from 2005 to 2023, embracing several study designs to provide a strong evidence foundation. Using diversion and relaxation strategies, VR can help pediatric cancer patients cope with the emotional issues they confront during operations. VR has shown significant potential for lowering pain and anxiety during several pediatric medical procedures. Patient feedback focused on VR’s empowering and anxiety-reducing benefits, while healthcare staff reported increased patient participation and procedural efficiency. VR implementation challenges include the cost of specialized technology, the need for specific virtual settings, and the need for training healthcare workers. VR shows promise in improving the pediatric cancer experience, but more study and cooperation are required to realize its full potential.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140383948","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}
This study included patients followed up for primary renal tubular acidosis (RTA) between 1991 and 2012. Clinical characteristics at presentation, physical examination findings, laboratory test results, and treatments were recorded. The patients’ laboratory results, drug doses, height, and weight were recorded every 3 months for the first year of follow-up. Standard deviation scores (Z-scores) of height and weight for age were determined and the patients’ growth rates were evaluated. Of 50 patients followed up for primary RTA, 31 (62%) had distal RTA and 19 (38%) had proximal RTA. The median age at diagnosis was 3 months (range, 1-174 months) for patients with distal RTA and 10 months (range, 2-33 months) for patients with proximal RTA. The median follow-up times in these two groups were 96 months (range, 6-204 months) and 89 months (range, 6-180 months), respectively. Family history of RTA was more common among patients with distal RTA than those with proximal RTA (p=0.013). Nephrocalcinosis and deafness were detected more frequently in the distal RTA group (p=0.001), while ocular pathologies were more common in the proximal RTA group (p<0.001). In patients with distal RTA, older age at diagnosis was associated with lower weight and height Z-scores (p<0.05). Early diagnosis had a positive effect on the growth of patients with primary RTA.
{"title":"Demographic, Clinical, and Laboratory Characteristics of Children with Renal Tubular Acidosis","authors":"Aybüke Yazıcı, Nilgün Çakar","doi":"10.4274/jpea.2023.242","DOIUrl":"https://doi.org/10.4274/jpea.2023.242","url":null,"abstract":"This study included patients followed up for primary renal tubular acidosis (RTA) between 1991 and 2012. Clinical characteristics at presentation, physical examination findings, laboratory test results, and treatments were recorded. The patients’ laboratory results, drug doses, height, and weight were recorded every 3 months for the first year of follow-up. Standard deviation scores (Z-scores) of height and weight for age were determined and the patients’ growth rates were evaluated. Of 50 patients followed up for primary RTA, 31 (62%) had distal RTA and 19 (38%) had proximal RTA. The median age at diagnosis was 3 months (range, 1-174 months) for patients with distal RTA and 10 months (range, 2-33 months) for patients with proximal RTA. The median follow-up times in these two groups were 96 months (range, 6-204 months) and 89 months (range, 6-180 months), respectively. Family history of RTA was more common among patients with distal RTA than those with proximal RTA (p=0.013). Nephrocalcinosis and deafness were detected more frequently in the distal RTA group (p=0.001), while ocular pathologies were more common in the proximal RTA group (p<0.001). In patients with distal RTA, older age at diagnosis was associated with lower weight and height Z-scores (p<0.05). Early diagnosis had a positive effect on the growth of patients with primary RTA.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"44 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228904","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}
Constipation is a prevalent issue in the pediatric population and is predominantly of functional origin. It often presents with symptoms such as abdominal pain, vomiting, and anorexia, making it a significant complaint among young patients. A comprehensive patient history and physical examination are typically sufficient for the diagnosis of functional constipation. Early intervention and patient and parent education are crucial for the success of treatment, which involves dietary adjustments, toilet training, and medical interventions. This review outlines an approach to managing constipation in children.
{"title":"Constipation in Children: An Example of A Conflict Situation","authors":"Derya Altay","doi":"10.4274/jpea.2023.257","DOIUrl":"https://doi.org/10.4274/jpea.2023.257","url":null,"abstract":"Constipation is a prevalent issue in the pediatric population and is predominantly of functional origin. It often presents with symptoms such as abdominal pain, vomiting, and anorexia, making it a significant complaint among young patients. A comprehensive patient history and physical examination are typically sufficient for the diagnosis of functional constipation. Early intervention and patient and parent education are crucial for the success of treatment, which involves dietary adjustments, toilet training, and medical interventions. This review outlines an approach to managing constipation in children.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"18 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139234874","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}
A. Ünalp, P. Karaoğlu, Merve Yavuz, İpek Burcu Parlak İbiş, Ünsal Yılmaz
The Coronavirus disease-2019 pandemic has led to the spread of telemedicine management of ketogenic diet therapy (KDT) in children with drug-resistant epilepsy (DRE). In this study, we evaluated the views and satisfaction of families about telemedicine and KDT management. Families of 25 children who underwent KDT for DRE were included in the 17-item questionnaire. Nearly half of the families had a primary education level. Most children with DRE were in the process of maintaining KDT. 88% of the families were applying KDT with telemedicine due to the pandemic. 60% of families found it difficult to start KDT via telemedicine, but 96% reported that reaching the KDT team via telemedicine was sufficient. The necessity of laboratory analyzes and evaluation of the results of the KDT team was evaluated as good in 72%, and their response when dietary changes or vitamin addition was required was evaluated as good in 68%. All families were satisfied with the management of the KDT team in emergencies. 60% of the family recommended others to follow the KDT with telemedicine at all times and 40% recommended them during the pandemic period. According to the results of our study, in selecting patients who will be started with telemedicine and KDT, it should be noted that the families have sufficient education levels. The use of the telemedicine method may be a good option in the presence of an experienced and trained team in KDT management.
{"title":"Evaluation of Families’ Views on Disease Management by Applying Telemedicine During the COVID-19 Pandemic","authors":"A. Ünalp, P. Karaoğlu, Merve Yavuz, İpek Burcu Parlak İbiş, Ünsal Yılmaz","doi":"10.4274/jpea.2022.228","DOIUrl":"https://doi.org/10.4274/jpea.2022.228","url":null,"abstract":"The Coronavirus disease-2019 pandemic has led to the spread of telemedicine management of ketogenic diet therapy (KDT) in children with drug-resistant epilepsy (DRE). In this study, we evaluated the views and satisfaction of families about telemedicine and KDT management. Families of 25 children who underwent KDT for DRE were included in the 17-item questionnaire. Nearly half of the families had a primary education level. Most children with DRE were in the process of maintaining KDT. 88% of the families were applying KDT with telemedicine due to the pandemic. 60% of families found it difficult to start KDT via telemedicine, but 96% reported that reaching the KDT team via telemedicine was sufficient. The necessity of laboratory analyzes and evaluation of the results of the KDT team was evaluated as good in 72%, and their response when dietary changes or vitamin addition was required was evaluated as good in 68%. All families were satisfied with the management of the KDT team in emergencies. 60% of the family recommended others to follow the KDT with telemedicine at all times and 40% recommended them during the pandemic period. According to the results of our study, in selecting patients who will be started with telemedicine and KDT, it should be noted that the families have sufficient education levels. The use of the telemedicine method may be a good option in the presence of an experienced and trained team in KDT management.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"357 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132705648","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}
The many benefits of breastfeeding for both the mother and infant are well known. Therefore, the conditions that influence breastfeeding are important. Therefore, we investigated the frequency of breast refusal in the newborn period and the associated maternal perinatal risk factors at an Şan Med Hospital in Şanlurfa. A total of 407 mother-infant pairs fulfilling the study’s inclusion criteria were enrolled. The percentage of breast refusal in infants was higher in young maternal and paternal age (<25 years), being the first child, and active or passive smoking exposure of the mother during pregnancy. The percentage of breast rejection was lower when the baby started to be breastfed within the first hour of birth. The percentages of infants experiencing breast rejection were found to be significantly higher in the absence of skin-to-skin contact following delivery and in the presence of prelactal feeding at the first 3 days than in their counterparts. The rate of breast rejection was found to be higher in infants fed with mixed or formula compared with infants fed only breast milk during the last 24 h. Multiple logistic regression analysis determined that the risk of breast rejection was higher in maternal smoking/exposure during pregnancy [adjusted odds ratio (aOR): 3.19, 95% confidence interval (CI): 1.01-10.06] and delayed initiation of breastfeeding after the first hour (aOR: 3.45, 95% CI: 1.09-11.0). Being in a smoke-free environment for pregnant women should be supported by an indoor smoking ban, and early initiation of breastfeeding in the first hour after birth should be encouraged.
{"title":"Breast Refusal and Maternal and Perinatal Risk Factors in the Newborn Period From a Single Center in Şanlıurfa","authors":"B. Güneş, S. Yalçın","doi":"10.4274/jpea.2022.229","DOIUrl":"https://doi.org/10.4274/jpea.2022.229","url":null,"abstract":"The many benefits of breastfeeding for both the mother and infant are well known. Therefore, the conditions that influence breastfeeding are important. Therefore, we investigated the frequency of breast refusal in the newborn period and the associated maternal perinatal risk factors at an Şan Med Hospital in Şanlurfa. A total of 407 mother-infant pairs fulfilling the study’s inclusion criteria were enrolled. The percentage of breast refusal in infants was higher in young maternal and paternal age (<25 years), being the first child, and active or passive smoking exposure of the mother during pregnancy. The percentage of breast rejection was lower when the baby started to be breastfed within the first hour of birth. The percentages of infants experiencing breast rejection were found to be significantly higher in the absence of skin-to-skin contact following delivery and in the presence of prelactal feeding at the first 3 days than in their counterparts. The rate of breast rejection was found to be higher in infants fed with mixed or formula compared with infants fed only breast milk during the last 24 h. Multiple logistic regression analysis determined that the risk of breast rejection was higher in maternal smoking/exposure during pregnancy [adjusted odds ratio (aOR): 3.19, 95% confidence interval (CI): 1.01-10.06] and delayed initiation of breastfeeding after the first hour (aOR: 3.45, 95% CI: 1.09-11.0). Being in a smoke-free environment for pregnant women should be supported by an indoor smoking ban, and early initiation of breastfeeding in the first hour after birth should be encouraged.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129579333","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}
Aysun Yahši, Emel Arslan, Beyza Nur Atay, Muhammed Yasin Gökdol, Seren Karaciğer, T. Erat, Hatice Kübra Konca, Seval Özen, B. Dinç, G. Bayhan
Infections caused by resistant Gram-negative bacteria are a serious public health problem, with Klebsiella spp. being the most common cause and increasing over the years. There is a striking increase in antibiotic resistance worldwide. The aim of this study was to retrospectively evaluate the characteristics and treatment of bloodstream infections (BSIs) caused by Klebsiella spp. and to identify possible risk factors for extended-spectrum β-lactamase (ESBL) resistance in our hospital between August 2019 and March 2023. Of 250 Klebsiella isolates, 112 (44.8%) were ESBL producers and 138 (55.2%) were ESBL nonproducers. Catheter-related BSIs (CRBSIs) accounted for 49.6% of infections and were more common in the ESBL nonproducer group. Most of the Klebsiella spp. were K. pneumoniae (233/250). Most of the infections were healthcare-associated infections (85.6%). Most patients had an underlying disease, the most common underlying disease in the ESBL-producing group was neurometabolic disease (26.8%), whereas in the ESBL-non-producing group it was malignancy (35.5%). The median age of the ESBL-producing group was 14 months and was younger (p=0.01). Previous antibiotic use in the last 30 days, especially aminoglycosides (p<0.006), β-lactam-β-lactamase inhibitor combinations (p<0.001) and cephalosporins (p<0.001), increased ESBL-resistant infection. Use of β-lactam-β-lactamase inhibitor combinations in the last 30 days increased the risk of ESBL resistance by approximately 7.4 times, and cephalosporins increased the risk by 5 times. In the ESBL-producing group, the median duration of treatment was longer at 14 days (p=0.01), and carbapenems were most commonly used (p<0.001). Thrombocytopenia (p=0.003), elevated C-reactive protein (p<0.001), CRBSI (p=0.009), presence of central venous catheter (p=0.03), urinary catheter (p<0.001), mechanical ventilation (p<0.001), intensive care admission (p=0.005), previous use of carbapenems, aminoglycosides, fluoroquinolones in the last 30 days (p=0.003, p=0.001, p=0.006, respectively) and colistin treatment (p<0.001) increased the risk of mortality. The 28-day mortality rate was 11.6%. Appropriate use of narrow-spectrum antibiotics and reduction of invasive procedures is important in reducing ESBL resistance and BSI-related mortality.
{"title":"Bloodstream Infections by Extendedspectrum β-lactamase-producing Klebsiella Species in Children","authors":"Aysun Yahši, Emel Arslan, Beyza Nur Atay, Muhammed Yasin Gökdol, Seren Karaciğer, T. Erat, Hatice Kübra Konca, Seval Özen, B. Dinç, G. Bayhan","doi":"10.4274/jpea.2022.238","DOIUrl":"https://doi.org/10.4274/jpea.2022.238","url":null,"abstract":"Infections caused by resistant Gram-negative bacteria are a serious public health problem, with Klebsiella spp. being the most common cause and increasing over the years. There is a striking increase in antibiotic resistance worldwide. The aim of this study was to retrospectively evaluate the characteristics and treatment of bloodstream infections (BSIs) caused by Klebsiella spp. and to identify possible risk factors for extended-spectrum β-lactamase (ESBL) resistance in our hospital between August 2019 and March 2023. Of 250 Klebsiella isolates, 112 (44.8%) were ESBL producers and 138 (55.2%) were ESBL nonproducers. Catheter-related BSIs (CRBSIs) accounted for 49.6% of infections and were more common in the ESBL nonproducer group. Most of the Klebsiella spp. were K. pneumoniae (233/250). Most of the infections were healthcare-associated infections (85.6%). Most patients had an underlying disease, the most common underlying disease in the ESBL-producing group was neurometabolic disease (26.8%), whereas in the ESBL-non-producing group it was malignancy (35.5%). The median age of the ESBL-producing group was 14 months and was younger (p=0.01). Previous antibiotic use in the last 30 days, especially aminoglycosides (p<0.006), β-lactam-β-lactamase inhibitor combinations (p<0.001) and cephalosporins (p<0.001), increased ESBL-resistant infection. Use of β-lactam-β-lactamase inhibitor combinations in the last 30 days increased the risk of ESBL resistance by approximately 7.4 times, and cephalosporins increased the risk by 5 times. In the ESBL-producing group, the median duration of treatment was longer at 14 days (p=0.01), and carbapenems were most commonly used (p<0.001). Thrombocytopenia (p=0.003), elevated C-reactive protein (p<0.001), CRBSI (p=0.009), presence of central venous catheter (p=0.03), urinary catheter (p<0.001), mechanical ventilation (p<0.001), intensive care admission (p=0.005), previous use of carbapenems, aminoglycosides, fluoroquinolones in the last 30 days (p=0.003, p=0.001, p=0.006, respectively) and colistin treatment (p<0.001) increased the risk of mortality. The 28-day mortality rate was 11.6%. Appropriate use of narrow-spectrum antibiotics and reduction of invasive procedures is important in reducing ESBL resistance and BSI-related mortality.","PeriodicalId":118905,"journal":{"name":"The Journal of Pediatric Academy","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126464124","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}
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