Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.12144
Hatice Yılmaz Dağlı, Fatih Şap, Mehmet Burhan Oflaz, Beray Selver Eklioğlu, Mehmet Emre Atabek, Tamer Baysal
Aim: This study was conducted to examine the electrocardiographic markers used in the risk assessment of cardiac arrhythmia in children with obesity. Materials and Methods: In this prospective study, 60 children aged 3-17 years with exogenous obesity and 60 age and sex-matched healthy controls were included. Demographic data, assessment of atrial and ventricular arrhythmia risk markers in electrocardiography, and standard echocardiography measurements were performed. Values of p<0.05 were considered significant. Results: The mean ages of the study and control groups were 11.51±3.48 years and 10.74±3.72 years, respectively. Both groups had 30 males and 30 females. The study group had significantly higher average mean body mass index (BMI) compared to the control group. In electrocardiographic examinations, P-wave dispersion, QT dispersion (QTd), corrected QTd (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT, and Tp-e/QTc values were significantly higher in the obese group compared to the control group. In echocardiographic examinations, the dimensions of the heart chambers and vascular structure and wall thicknesses were found to be significantly higher in those children with obesity. Conclusion: The electrocardiographic risk markers used to predict cardiac arrhythmias were found to be increased in those children with obesity. This may suggest that increased body weight and adiposity may have unfavorable effects on the cardiac conduction system.
{"title":"Evaluation of Electrocardiographic Markers for the Risk of Cardiac Arrhythmia in Children with Obesity","authors":"Hatice Yılmaz Dağlı, Fatih Şap, Mehmet Burhan Oflaz, Beray Selver Eklioğlu, Mehmet Emre Atabek, Tamer Baysal","doi":"10.4274/jpr.galenos.2023.12144","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.12144","url":null,"abstract":"Aim: This study was conducted to examine the electrocardiographic markers used in the risk assessment of cardiac arrhythmia in children with obesity. Materials and Methods: In this prospective study, 60 children aged 3-17 years with exogenous obesity and 60 age and sex-matched healthy controls were included. Demographic data, assessment of atrial and ventricular arrhythmia risk markers in electrocardiography, and standard echocardiography measurements were performed. Values of p<0.05 were considered significant. Results: The mean ages of the study and control groups were 11.51±3.48 years and 10.74±3.72 years, respectively. Both groups had 30 males and 30 females. The study group had significantly higher average mean body mass index (BMI) compared to the control group. In electrocardiographic examinations, P-wave dispersion, QT dispersion (QTd), corrected QTd (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT, and Tp-e/QTc values were significantly higher in the obese group compared to the control group. In echocardiographic examinations, the dimensions of the heart chambers and vascular structure and wall thicknesses were found to be significantly higher in those children with obesity. Conclusion: The electrocardiographic risk markers used to predict cardiac arrhythmias were found to be increased in those children with obesity. This may suggest that increased body weight and adiposity may have unfavorable effects on the cardiac conduction system.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304947","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}
cardiovascular disease due to inflammation and autoimmunity involved in its pathophysiology. We aimed to evaluate vascular involvement in children with celiac disease based on their augmentation index, carotid pulse wave velocity, carotid intima-media thickness, echocardiographic findings, and blood pressure. Materials and Methods: This cross-sectional and controlled study was performed at a single center between 2018 and 2019. The study population consisted of 44 patients with celiac disease who had been on a gluten-free diet for at least one year. Results: We compared celiac patients with a healthy group. While the celiac patients had significantly higher carotid intima media thickness and carotid pulse wave velocity values, there was no difference in the augmentation index values. There was no significant difference in carotid artery intimal medial thickness, augmentation index and carotid pulse wave velocity values between the diet-compliant and non-compliant groups. Conclusion: Although hypertension was not detected, arterial stiffness and carotid intima media thickness measurements were higher in the celiac disease patients compared to the healthy controls. This showed that these parameters can be used in early vascular damage assessment. These measurements, which are non-invasive and repeatable, can be a guide for the monitoring of the development of preclinical atherosclerosis in the follow-up of the pediatric patients diagnosed with celiac disease.
{"title":"Evaluation of Vascular Involvement in Children with Celiac Disease","authors":"Ezgi Kıran Taşcı, Sevgin Taner, Eser Doğan, Miray Karakoyun, İpek Kaplan Bulut, Caner Kabasakal, Ertürk Levent, Funda Çetin, Sema Aydoğdu","doi":"10.4274/jpr.galenos.2023.67503","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.67503","url":null,"abstract":"cardiovascular disease due to inflammation and autoimmunity involved in its pathophysiology. We aimed to evaluate vascular involvement in children with celiac disease based on their augmentation index, carotid pulse wave velocity, carotid intima-media thickness, echocardiographic findings, and blood pressure. Materials and Methods: This cross-sectional and controlled study was performed at a single center between 2018 and 2019. The study population consisted of 44 patients with celiac disease who had been on a gluten-free diet for at least one year. Results: We compared celiac patients with a healthy group. While the celiac patients had significantly higher carotid intima media thickness and carotid pulse wave velocity values, there was no difference in the augmentation index values. There was no significant difference in carotid artery intimal medial thickness, augmentation index and carotid pulse wave velocity values between the diet-compliant and non-compliant groups. Conclusion: Although hypertension was not detected, arterial stiffness and carotid intima media thickness measurements were higher in the celiac disease patients compared to the healthy controls. This showed that these parameters can be used in early vascular damage assessment. These measurements, which are non-invasive and repeatable, can be a guide for the monitoring of the development of preclinical atherosclerosis in the follow-up of the pediatric patients diagnosed with celiac disease.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304943","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}
Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.48753
Eren Er, Aysun Ata, Ali Orgun
Aim: Gonadotropin-releasing hormone analogs (GnRHa) are standard medical treatments for precocious puberty. Studies on their side effects in adults have shown that these drugs can cause changes in electrocardiography (ECG), along with some cardiovascular effects; however, the number of studies on children is limited. This study investigated the effects of these drugs on ECG parameters in children diagnosed with central precocious puberty (CPP). Materials and Methods: This prospective study included 44 girls who were initiated GnRHa treatment and diagnosed with CPP. ECG was performed before treatment and repeated after 6 months of treatment. Results: The mean age of the children was 9.13±1.55 years. Leuprolide acetate (3.75 mg IM) was administered to all of the patients following the standard protocol. A comparison of the pre-treatment and 6-month ECG parameters revealed a prolonged QT interval after treatment, with a statistically significant difference (p<0.001). There were no significant differences in the pre-and post-treatment values of PR, QRS, QT interval, QTc interval, QT dispersion, or QTc dispersion (p>0.05). Conclusion: Despite a significant increase in QT interval on ECG with GnRHa compared to pre-treatment ECGs, this increase was attributed to a variability in heart rate. Even if regular ECG monitoring is considered after initiation of GnRHa treatment, they are believed to be safe drugs in children.
{"title":"Evaluation of Electrocardiographic Changes in Girls Receiving Gonadotropin-Releasing Hormone Analogs for Precocious Puberty","authors":"Eren Er, Aysun Ata, Ali Orgun","doi":"10.4274/jpr.galenos.2023.48753","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.48753","url":null,"abstract":"Aim: Gonadotropin-releasing hormone analogs (GnRHa) are standard medical treatments for precocious puberty. Studies on their side effects in adults have shown that these drugs can cause changes in electrocardiography (ECG), along with some cardiovascular effects; however, the number of studies on children is limited. This study investigated the effects of these drugs on ECG parameters in children diagnosed with central precocious puberty (CPP). Materials and Methods: This prospective study included 44 girls who were initiated GnRHa treatment and diagnosed with CPP. ECG was performed before treatment and repeated after 6 months of treatment. Results: The mean age of the children was 9.13±1.55 years. Leuprolide acetate (3.75 mg IM) was administered to all of the patients following the standard protocol. A comparison of the pre-treatment and 6-month ECG parameters revealed a prolonged QT interval after treatment, with a statistically significant difference (p<0.001). There were no significant differences in the pre-and post-treatment values of PR, QRS, QT interval, QTc interval, QT dispersion, or QTc dispersion (p>0.05). Conclusion: Despite a significant increase in QT interval on ECG with GnRHa compared to pre-treatment ECGs, this increase was attributed to a variability in heart rate. Even if regular ECG monitoring is considered after initiation of GnRHa treatment, they are believed to be safe drugs in children.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304945","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}
Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.33341
Gülşen İlgen, Dilşah Çoğulu, Ege Uçan, Ataç Uzel
Aim: Tooth discoloration is a common clinical finding which is considered primarily as an aesthetic problem. Black stain (BS) is a specific type of extrinsic tooth discoloration mostly seen in children, but also in adults and it is not dependent on gender. The present study aimed to investigate the relationships between the presence of BS and dental caries incidence, dental plaque scores and to examine the colonization of Streptococcus mutans , Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. in dental plaque samples with or without BS. The socioeconomic status of the family, the oral hygiene and dietary habits of the children, and the medical and dental history of the children were also compared between the two groups. Materials and Methods: A total of 1000 children aged 3-12 years were evaluated to take part in this study. From this group, those children with BS (n=44) were selected as the study group. With the same number as the study group, and with a same age and gender profile, 44 children without BS were selected as a control group. Dental examinations including the presence of BS, dental caries incidence and dental plaque scores were performed by the same investigator. Structured questionnaires were completed by the parents. The levels of S. mutans , Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. were determined from dental plaque samples. All data were analyzed by SPPS 25.0 using Student’s t-test, the Mann-Whitney U, Fisher’s exact and the chi-squared tests. Results: BS was detected in 4.4% of the patients in the present study. DMFT and DMFS scores were significantly lower in those children with BS than in those without BS (p=0.001 and p=0.010). However, no statistically significant difference was found between dmft and dmfs scores and the presence of BS (p>0.05). Lower numbers of S. mutans and Lactobacillus spp. and greater numbers of Actinomyces spp. and Capnocytophaga spp. were found in those children with BS. There was no statistically significant relationship between S. mutans and Actinomyces spp. and the presence of BS (p>0.05). Colonizations of Lactobacillus spp. were statistically significantly lower, while colonizations of Capnocytophaga spp. were significantly higher in the BS group than in the control group (p<0.05). Conclusion: It could be suggested that the different microbial composition of BS might be associated with lower caries experiences in affected subjects.
{"title":"Evaluation of the Etiological Factors of Black Tooth Stain in Children","authors":"Gülşen İlgen, Dilşah Çoğulu, Ege Uçan, Ataç Uzel","doi":"10.4274/jpr.galenos.2023.33341","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.33341","url":null,"abstract":"Aim: Tooth discoloration is a common clinical finding which is considered primarily as an aesthetic problem. Black stain (BS) is a specific type of extrinsic tooth discoloration mostly seen in children, but also in adults and it is not dependent on gender. The present study aimed to investigate the relationships between the presence of BS and dental caries incidence, dental plaque scores and to examine the colonization of Streptococcus mutans , Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. in dental plaque samples with or without BS. The socioeconomic status of the family, the oral hygiene and dietary habits of the children, and the medical and dental history of the children were also compared between the two groups. Materials and Methods: A total of 1000 children aged 3-12 years were evaluated to take part in this study. From this group, those children with BS (n=44) were selected as the study group. With the same number as the study group, and with a same age and gender profile, 44 children without BS were selected as a control group. Dental examinations including the presence of BS, dental caries incidence and dental plaque scores were performed by the same investigator. Structured questionnaires were completed by the parents. The levels of S. mutans , Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. were determined from dental plaque samples. All data were analyzed by SPPS 25.0 using Student’s t-test, the Mann-Whitney U, Fisher’s exact and the chi-squared tests. Results: BS was detected in 4.4% of the patients in the present study. DMFT and DMFS scores were significantly lower in those children with BS than in those without BS (p=0.001 and p=0.010). However, no statistically significant difference was found between dmft and dmfs scores and the presence of BS (p>0.05). Lower numbers of S. mutans and Lactobacillus spp. and greater numbers of Actinomyces spp. and Capnocytophaga spp. were found in those children with BS. There was no statistically significant relationship between S. mutans and Actinomyces spp. and the presence of BS (p>0.05). Colonizations of Lactobacillus spp. were statistically significantly lower, while colonizations of Capnocytophaga spp. were significantly higher in the BS group than in the control group (p<0.05). Conclusion: It could be suggested that the different microbial composition of BS might be associated with lower caries experiences in affected subjects.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304936","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}
Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.37630
Canan Salman Önemli, Kübra Evren Şahin, Özge Atacan
Aim: The purpose of this study was to assess the prognostic power of preoperative laboratory biomarkers in pediatric age group individuals diagnosed with appendicitis in the emergency department in distinguishing complicated appendicitis from non-complicated appendicitis and in predicting postoperative outcomes. Materials and Methods: The population of this descriptive, cross-sectional, retrospective study consisted of children (younger than 18 years of age) who applied to our hospital’s emergency department between January, 2020 and October, 2021 and underwent surgical intervention with a diagnosis of acute appendicitis. Preoperative laboratory test results, intraoperative surgical outcomes, lengths of hospital stay and postoperative complications data were recorded in the patient follow-up forms and analyzed. Results: The intraoperative and pathological data revealed that 179 (37.8%) and 294 (62.1%) patients had complicated and non-complicated appendicitis, respectively. An analysis of the complete blood count results indicated that the C-reactive protein (CRP) level, and CRP-to-albumin ratio (CAR), neutrophil count, leukocyte count, monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) were significantly higher, whereas the sodium and albumin levels were significantly lower in those patients with complicated appendicitis than in those with non-complicated appendicitis. Among the parameters investigated, the NLR, CAR values, and the presence of hyponatremia were found to be significantly associated with the length of hospital stay and postoperative complication rates in those patients with complicated appendicitis. Conclusion: The findings of our study show that leukocyte counts, neutrophil counts, NLR values, CRP, sodium, and direct bilirubin levels measured preoperatively in the emergency department can be used to identify pediatric patients with complicated appendicitis. In addition, MLR and CAR values, as new biomarkers, can provide guidance in emergency interventions and also predict postoperative outcomes.
{"title":"Assessment of the Prognostic Power of Preoperative Laboratory Biomarkers in Predicting Pediatric Complicated Appendicitis and the Outcomes of the Relevant Surgical Intervention","authors":"Canan Salman Önemli, Kübra Evren Şahin, Özge Atacan","doi":"10.4274/jpr.galenos.2023.37630","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.37630","url":null,"abstract":"Aim: The purpose of this study was to assess the prognostic power of preoperative laboratory biomarkers in pediatric age group individuals diagnosed with appendicitis in the emergency department in distinguishing complicated appendicitis from non-complicated appendicitis and in predicting postoperative outcomes. Materials and Methods: The population of this descriptive, cross-sectional, retrospective study consisted of children (younger than 18 years of age) who applied to our hospital’s emergency department between January, 2020 and October, 2021 and underwent surgical intervention with a diagnosis of acute appendicitis. Preoperative laboratory test results, intraoperative surgical outcomes, lengths of hospital stay and postoperative complications data were recorded in the patient follow-up forms and analyzed. Results: The intraoperative and pathological data revealed that 179 (37.8%) and 294 (62.1%) patients had complicated and non-complicated appendicitis, respectively. An analysis of the complete blood count results indicated that the C-reactive protein (CRP) level, and CRP-to-albumin ratio (CAR), neutrophil count, leukocyte count, monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) were significantly higher, whereas the sodium and albumin levels were significantly lower in those patients with complicated appendicitis than in those with non-complicated appendicitis. Among the parameters investigated, the NLR, CAR values, and the presence of hyponatremia were found to be significantly associated with the length of hospital stay and postoperative complication rates in those patients with complicated appendicitis. Conclusion: The findings of our study show that leukocyte counts, neutrophil counts, NLR values, CRP, sodium, and direct bilirubin levels measured preoperatively in the emergency department can be used to identify pediatric patients with complicated appendicitis. In addition, MLR and CAR values, as new biomarkers, can provide guidance in emergency interventions and also predict postoperative outcomes.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304941","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}
{"title":"Evaluation of the Association Between Sleeping Arrangements and Breastfeeding in Infants: A Cross-Sectional, Single Unit Study","authors":"Tuğba Burcu Öztürk, Şule Gökçe, Merve Tosyalı, Feyza Umay Koç","doi":"10.4274/jpr.galenos.2023.98965","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.98965","url":null,"abstract":".","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304942","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}
Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.25986
Sevgin Taner, Sabire Şöhret Aydemir, Su Özgür, Ezgi Aksoy, Ahmet Keskinoğlu, Alper Tünger, Caner Kabasakal, İpek Kaplan Bulut
Aim: Urinary tract infection (UTI) is one of the most common bacterial infections in children. Empirical treatment is commenced according to the patient’s characteristics and the antimicrobial susceptibility patterns in the region. Therefore, a determination of antimicrobial resistance patterns has a great importance in effective treatment. The aim of this study was to determine the pathogens which cause UTIs in patients admitted to a university hospital in Izmir and to determine their antimicrobial susceptibility pattern. Materials and Methods: The files of patients aged between 0-18 years, followed up with a diagnosis of UTI, vesicoureteral reflux and neurogenic bladder in Ege University Faculty of Medicine Paediatric Nephrology Unit between February, 2013 and November, 2018 were retrospectively reviewed. Results: A total of 1,126 positive urine cultures from 729 patients (65% female) were included in this study. Gram-negative pathogens constituted 88.2% of the cultures. Escherichia coli ( E. coli ) was the most commonly isolated bacteria with a prevalence of 59.1%, followed by Klebsiella pneumonia with 17.9%, and Enterococcus faecalis with 8.3% (n=93). Ampicillin, cefuroxime and trimethoprim-sulfamethoxazole with susceptibility rates of 18.6%, 39.6%, 49.0% respectively, constituted the highest resistant antimicrobials to Enterobacteriaceae . Enterococcus spp. showed the highest resistance to gentamycin with 50% resistance in tested cases. Pseudomonas spp. with 64.3% susceptibility showed the highest resistance to piperacillin-tazobactam. Conclusion: This study revealed that bacterial resistance to commonly used antimicrobials in UTI is an important and challenging problem which requires planning.
{"title":"<i>In vitro</i> Antimicrobial Susceptibility of Urinary Tract Infection Pathogens in Children","authors":"Sevgin Taner, Sabire Şöhret Aydemir, Su Özgür, Ezgi Aksoy, Ahmet Keskinoğlu, Alper Tünger, Caner Kabasakal, İpek Kaplan Bulut","doi":"10.4274/jpr.galenos.2023.25986","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.25986","url":null,"abstract":"Aim: Urinary tract infection (UTI) is one of the most common bacterial infections in children. Empirical treatment is commenced according to the patient’s characteristics and the antimicrobial susceptibility patterns in the region. Therefore, a determination of antimicrobial resistance patterns has a great importance in effective treatment. The aim of this study was to determine the pathogens which cause UTIs in patients admitted to a university hospital in Izmir and to determine their antimicrobial susceptibility pattern. Materials and Methods: The files of patients aged between 0-18 years, followed up with a diagnosis of UTI, vesicoureteral reflux and neurogenic bladder in Ege University Faculty of Medicine Paediatric Nephrology Unit between February, 2013 and November, 2018 were retrospectively reviewed. Results: A total of 1,126 positive urine cultures from 729 patients (65% female) were included in this study. Gram-negative pathogens constituted 88.2% of the cultures. Escherichia coli ( E. coli ) was the most commonly isolated bacteria with a prevalence of 59.1%, followed by Klebsiella pneumonia with 17.9%, and Enterococcus faecalis with 8.3% (n=93). Ampicillin, cefuroxime and trimethoprim-sulfamethoxazole with susceptibility rates of 18.6%, 39.6%, 49.0% respectively, constituted the highest resistant antimicrobials to Enterobacteriaceae . Enterococcus spp. showed the highest resistance to gentamycin with 50% resistance in tested cases. Pseudomonas spp. with 64.3% susceptibility showed the highest resistance to piperacillin-tazobactam. Conclusion: This study revealed that bacterial resistance to commonly used antimicrobials in UTI is an important and challenging problem which requires planning.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304939","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}
Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.96992
Ayşe Ergül Bozacı, Emine Göksoy, Aysel Tekmenuray Ünal, Hatice Mutlu Albayrak, İbrahim Taş, Berat Kanar, Mehmet Nuri Özbek, Melis Köse
Aim: Urea cycle disorders (UCD) still have poor neurological outcomes despite early diagnosis and treatment. We aimed to present the neurological outcomes of UCD patients and to determine the main simple and accessible factors affecting these outcomes. Materials and Methods: This was a descriptive cross-sectional study conducted in two pediatric metabolism centers on 29 patients from 25 unrelated families who were diagnosed and followed with UCD based on clinical presentation, neurological parameters, biochemical measurements, and molecular analysis. Results: Within the study population, the most common diagnosis was argininosuccinate synthase deficiency in 13 (44.82%) patients, followed by N-acetylglutamate synthase deficiency in five patients (17.24%), ornithine transcarbamylase deficiency in four patients (13.79%), arginase 1 deficiency in three patients (10.34%), carbamoyl phosphate synthase 1 deficiency in three patients (10.34%), and argininosuccinate lyase deficiency in one patient (3.44%). Peak ammonia levels were observed to be significantly higher in those patients with delayed milestones and patients who had Denver II <-2 standard deviation score results (p=0.032, p=0.026). Effect sizes were large in both groups. Delayed milestones were noted in 17 (94.4%) of the cases with peak ammonia >500 μmol/L (n=18). Those patients with abnormal neurological parameters had a significantly higher mean number of hyperammonemic episodes per year. Extracorporeal detoxification was given to eight patients, in combination with therapeutic hypothermia in two patients. Rapid regression was observed in brain edema in those who underwent therapeutic hypothermia. Conclusion: Our study emphasizes the effect of peak ammonia levels and the frequency of hyperammonemic episodes on neurological outcomes. There were still poor neurocognitive outcomes despite extracorporeal detoxification. This highlights the need to reassess current treatment strategies, including the threshold for starting extracorporeal detoxification if ammonia levels exceed 500 μmol/L. The use of therapeutic hypothermia by experienced teams may be promising due to its brain edema-reducing effects.
{"title":"Evaluation of the Neurodevelopmental Status for Urea Cycle Disorders: Based on Clinical Experience","authors":"Ayşe Ergül Bozacı, Emine Göksoy, Aysel Tekmenuray Ünal, Hatice Mutlu Albayrak, İbrahim Taş, Berat Kanar, Mehmet Nuri Özbek, Melis Köse","doi":"10.4274/jpr.galenos.2023.96992","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.96992","url":null,"abstract":"Aim: Urea cycle disorders (UCD) still have poor neurological outcomes despite early diagnosis and treatment. We aimed to present the neurological outcomes of UCD patients and to determine the main simple and accessible factors affecting these outcomes. Materials and Methods: This was a descriptive cross-sectional study conducted in two pediatric metabolism centers on 29 patients from 25 unrelated families who were diagnosed and followed with UCD based on clinical presentation, neurological parameters, biochemical measurements, and molecular analysis. Results: Within the study population, the most common diagnosis was argininosuccinate synthase deficiency in 13 (44.82%) patients, followed by N-acetylglutamate synthase deficiency in five patients (17.24%), ornithine transcarbamylase deficiency in four patients (13.79%), arginase 1 deficiency in three patients (10.34%), carbamoyl phosphate synthase 1 deficiency in three patients (10.34%), and argininosuccinate lyase deficiency in one patient (3.44%). Peak ammonia levels were observed to be significantly higher in those patients with delayed milestones and patients who had Denver II <-2 standard deviation score results (p=0.032, p=0.026). Effect sizes were large in both groups. Delayed milestones were noted in 17 (94.4%) of the cases with peak ammonia >500 μmol/L (n=18). Those patients with abnormal neurological parameters had a significantly higher mean number of hyperammonemic episodes per year. Extracorporeal detoxification was given to eight patients, in combination with therapeutic hypothermia in two patients. Rapid regression was observed in brain edema in those who underwent therapeutic hypothermia. Conclusion: Our study emphasizes the effect of peak ammonia levels and the frequency of hyperammonemic episodes on neurological outcomes. There were still poor neurocognitive outcomes despite extracorporeal detoxification. This highlights the need to reassess current treatment strategies, including the threshold for starting extracorporeal detoxification if ammonia levels exceed 500 μmol/L. The use of therapeutic hypothermia by experienced teams may be promising due to its brain edema-reducing effects.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304937","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}
Pub Date : 2023-09-01DOI: 10.4274/jpr.galenos.2023.30111
Yasemin Atik Altınok, Damla Gökşen
Aim: The aim of this study was to evaluate the dietary macronutrient distribution affects on serum lipid profiles in type 1 diabetes mellitus (T1D). Materials and Methods: This cross-sectional study included 82 children and adolescents between the ages of 2 and 18 years with a diabetes age of ≥1 year. Dietary intake was evaluated by 3-day food diaries, including three consecutive days (two weekdays and one weekend day). Results: The mean age of the 82 patients with diabetes was 11.6±4.3 years (range: 2-18 years) (45.1% female), the median diabetes duration was 3.4 (2.9) years, the mean HbA1c level was 7.0±1.4%, and mean body mass index standard deviation score was 0.2±1.1. The median distribution of energy from carbohydrates, protein and fat in the total energy intake was 50.0% (6.2), 17.4% (2.7) and 32.5% (5.1), respectively. Dietary fiber intake was inadequate in 64 (77.9%) participants, while for 77 participants (93.9%), saturated fatty acid intake was above the recommended intake. For children and adolescents with T1D, mean serum cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein levels were 162.9±33.4 mg/dL, 86.2±49 mg/dL, 87.9±29.2 mg/dL, and 60.7±17.9 mg/dL, respectively. Conclusion: To maintain healthy eating, consuming foods high in saturated fat should be limited, and children and adolescents with T1D should be supported by their family and healthcare professionals in the consumption of diets high in fiber.
{"title":"Is Dietary Macronutrient Distribution Related to Serum Lipid Profiles in Children and Adolescents with Type 1 Diabetes?","authors":"Yasemin Atik Altınok, Damla Gökşen","doi":"10.4274/jpr.galenos.2023.30111","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.30111","url":null,"abstract":"Aim: The aim of this study was to evaluate the dietary macronutrient distribution affects on serum lipid profiles in type 1 diabetes mellitus (T1D). Materials and Methods: This cross-sectional study included 82 children and adolescents between the ages of 2 and 18 years with a diabetes age of ≥1 year. Dietary intake was evaluated by 3-day food diaries, including three consecutive days (two weekdays and one weekend day). Results: The mean age of the 82 patients with diabetes was 11.6±4.3 years (range: 2-18 years) (45.1% female), the median diabetes duration was 3.4 (2.9) years, the mean HbA1c level was 7.0±1.4%, and mean body mass index standard deviation score was 0.2±1.1. The median distribution of energy from carbohydrates, protein and fat in the total energy intake was 50.0% (6.2), 17.4% (2.7) and 32.5% (5.1), respectively. Dietary fiber intake was inadequate in 64 (77.9%) participants, while for 77 participants (93.9%), saturated fatty acid intake was above the recommended intake. For children and adolescents with T1D, mean serum cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein levels were 162.9±33.4 mg/dL, 86.2±49 mg/dL, 87.9±29.2 mg/dL, and 60.7±17.9 mg/dL, respectively. Conclusion: To maintain healthy eating, consuming foods high in saturated fat should be limited, and children and adolescents with T1D should be supported by their family and healthcare professionals in the consumption of diets high in fiber.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304938","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}
Aim: Traumas are the most common cause of mortality and morbidity in children. Coronavirus disease-2019 (COVID-19) was shown to affect pediatric mental health, child neglect, and the occurrence of traumatic injuries. This study aimed to characterize pediatric trauma cases presenting to our institution before and after the pandemic began. Materials and Methods: Patients with trauma who were admitted to our emergency department between March, 2019 and March, 2021 were included. The patients were classified into two groups as before and after the pandemic began (March, 2020). Trauma characteristics, the severity of the injury, and prognosis were assessed. The patients’ injury severity scores (ISS) and pediatric trauma scores (PTS) were noted. Results: A total of 1,718 patients were included in this study. The number of pediatric trauma admissions dropped from 1,039 to 679 after the pandemic started. There was no difference between these groups in terms of age (p=0.874) or gender (p=0.106). There was a significant decrease in the number of traumatic injuries (p<0.001) especially during the first shutdown period (April, May, and June, 2020. Additionally, there was a significant increase in terms of foreign body aspiration (p=0.001) and pedestrian injuries (p=0.016). Although a significant increase was noted in the ISS of the patients (p<0.001), no differences were found between the PTSs (p=0.075) or multi-organ injuries (p=1.000). Also, no significant differences were observed regarding mortality (p=0.650), household accidents (p=0.600), trauma type (p=0.533), the need for transfusion (p=0.166), surgery (p=0.077) or mechanical ventilation (p=0.464) between the two groups. Conclusion: The COVID-19 pandemic altered social patterns, leading to a decrease in pediatric traumas. This decrease was most prominent during the shutdown period. The variables showing severe trauma, such as the need for surgery, did not change despite a significant increase in ISS. This was attributed to a decrease in admissions for minor trauma.
{"title":"Changes in Pediatric Trauma During the COVID-19 Pandemic; Does the Pandemic Have an Effect on the Severity of Traumas?","authors":"Dilnur Sevinç, Aslıhan Nallı, Bade Toker Kurtmen, Emine Burcu Çığşar Kuzu, Mustafa Onur Öztan","doi":"10.4274/jpr.galenos.2023.45389","DOIUrl":"https://doi.org/10.4274/jpr.galenos.2023.45389","url":null,"abstract":"Aim: Traumas are the most common cause of mortality and morbidity in children. Coronavirus disease-2019 (COVID-19) was shown to affect pediatric mental health, child neglect, and the occurrence of traumatic injuries. This study aimed to characterize pediatric trauma cases presenting to our institution before and after the pandemic began. Materials and Methods: Patients with trauma who were admitted to our emergency department between March, 2019 and March, 2021 were included. The patients were classified into two groups as before and after the pandemic began (March, 2020). Trauma characteristics, the severity of the injury, and prognosis were assessed. The patients’ injury severity scores (ISS) and pediatric trauma scores (PTS) were noted. Results: A total of 1,718 patients were included in this study. The number of pediatric trauma admissions dropped from 1,039 to 679 after the pandemic started. There was no difference between these groups in terms of age (p=0.874) or gender (p=0.106). There was a significant decrease in the number of traumatic injuries (p<0.001) especially during the first shutdown period (April, May, and June, 2020. Additionally, there was a significant increase in terms of foreign body aspiration (p=0.001) and pedestrian injuries (p=0.016). Although a significant increase was noted in the ISS of the patients (p<0.001), no differences were found between the PTSs (p=0.075) or multi-organ injuries (p=1.000). Also, no significant differences were observed regarding mortality (p=0.650), household accidents (p=0.600), trauma type (p=0.533), the need for transfusion (p=0.166), surgery (p=0.077) or mechanical ventilation (p=0.464) between the two groups. Conclusion: The COVID-19 pandemic altered social patterns, leading to a decrease in pediatric traumas. This decrease was most prominent during the shutdown period. The variables showing severe trauma, such as the need for surgery, did not change despite a significant increase in ISS. This was attributed to a decrease in admissions for minor trauma.","PeriodicalId":42409,"journal":{"name":"Journal of Pediatric Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304940","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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