Objectives: Bipolar disorder (BD) is a prevalent psychological disorder associated with depressive symptoms. Transcranial direct current stimulation (tDCS) is a portable and non-invasive technique for brain stimulation. The present study was conducted to determine the effectiveness of the combined treatment of tDCS and routine medication on the symptoms of depression, anxiety, and anger in BD adolescents. Methods: In this double-blind randomized clinical trial study, forty adolescents with BD referred to the outpatient clinic of child and psychiatry of Golestan Ahvaz Teaching Hospital were included. Eligible patients aged 12 - 18 years were randomly divided into 2 groups receiving routine medications plus active tDCS (intervention group) or routine medications plus sham tDCS (control group). Transcranial direct current stimulation intervention with an intensity of 2 mA was applied to the dorsolateral prefrontal cortex in two sessions for 20 minutes each day, for 5 consecutive days. Data were collected at baseline, one week, and one month after the start of the intervention using the Hamilton Depression Rating Scale (HDRS-21), Hamilton Anxiety Rating Scale (HDRS), and State-Trait Anger Expression Inventory. Results: Based on our findings, age and gender were not considerably different between the two groups (P = 0.592, P = 0.1, respectively). In both groups, scores of depression (control: 12.25 ± 3.97, intervention: 0.75 ± 1.44, mean [SD]), anxiety (13.55 ± 2.58, 25.0 ± 0.55), and anger (52.65 ± 8.27, 47.25 ± 4.86) improved significantly one month after treatment (P < 0.0001). After one month of treatment, the severity of bipolar symptoms in the intervention group (slightly: 10%, moderately: 50%, and markedly: 40%) improved significantly compared to the control group (slightly: 15%, moderately: 10%, and markedly: 0%) (P < 0.0001). The improvement rate of HDRS in the intervention group was 81.29% and 95.24% at one week and one month after treatment, while these values were 8.41% and 23.04% in the control group, respectively (P < 0.0001). All patients tolerated the treatment well without serious side effects. There was no significant difference between the side effects observed in both groups (P = 0.185). Conclusions: The combination of tDCS with routine medications can reduce depressive symptoms and improve bipolar symptoms. Therefore, tDCS add-on could be an effective, safe, and tolerable intervention for bipolar depression.
{"title":"Effectiveness of Combined Treatment of Transcranial Direct Current Stimulation and Treatment as Usual on Depression, Anxiety and Anger in Adolescents with Bipolar Disorder","authors":"Forugh Riahi, Ashraf Tashakori, Maryam Izadi Mazidi, Saeideh Farjadnia","doi":"10.5812/jcp-142787","DOIUrl":"https://doi.org/10.5812/jcp-142787","url":null,"abstract":"Objectives: Bipolar disorder (BD) is a prevalent psychological disorder associated with depressive symptoms. Transcranial direct current stimulation (tDCS) is a portable and non-invasive technique for brain stimulation. The present study was conducted to determine the effectiveness of the combined treatment of tDCS and routine medication on the symptoms of depression, anxiety, and anger in BD adolescents. Methods: In this double-blind randomized clinical trial study, forty adolescents with BD referred to the outpatient clinic of child and psychiatry of Golestan Ahvaz Teaching Hospital were included. Eligible patients aged 12 - 18 years were randomly divided into 2 groups receiving routine medications plus active tDCS (intervention group) or routine medications plus sham tDCS (control group). Transcranial direct current stimulation intervention with an intensity of 2 mA was applied to the dorsolateral prefrontal cortex in two sessions for 20 minutes each day, for 5 consecutive days. Data were collected at baseline, one week, and one month after the start of the intervention using the Hamilton Depression Rating Scale (HDRS-21), Hamilton Anxiety Rating Scale (HDRS), and State-Trait Anger Expression Inventory. Results: Based on our findings, age and gender were not considerably different between the two groups (P = 0.592, P = 0.1, respectively). In both groups, scores of depression (control: 12.25 ± 3.97, intervention: 0.75 ± 1.44, mean [SD]), anxiety (13.55 ± 2.58, 25.0 ± 0.55), and anger (52.65 ± 8.27, 47.25 ± 4.86) improved significantly one month after treatment (P < 0.0001). After one month of treatment, the severity of bipolar symptoms in the intervention group (slightly: 10%, moderately: 50%, and markedly: 40%) improved significantly compared to the control group (slightly: 15%, moderately: 10%, and markedly: 0%) (P < 0.0001). The improvement rate of HDRS in the intervention group was 81.29% and 95.24% at one week and one month after treatment, while these values were 8.41% and 23.04% in the control group, respectively (P < 0.0001). All patients tolerated the treatment well without serious side effects. There was no significant difference between the side effects observed in both groups (P = 0.185). Conclusions: The combination of tDCS with routine medications can reduce depressive symptoms and improve bipolar symptoms. Therefore, tDCS add-on could be an effective, safe, and tolerable intervention for bipolar depression.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"47 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140361549","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}
Background: Functional constipation (FC) is a common issue in pediatric healthcare, causing significant physical and emotional distress for patients and their families. Objectives: This study aimed to investigate the prevalence of behavioral issues in children diagnosed with functional constipation, exploring their characteristics and relationship with various factors. Methods: We conducted a case-control study involving 107 children and adolescents (aged 2 to 18 years) with chronic functional constipation as the case group and 107 children without this condition as the control group. The Strengths and Difficulties Questionnaire (SDQ) was employed to evaluate different aspects of behavioral patterns. Results: The comparison of various behavioral components assessed by the SDQ between the case and control groups revealed significantly higher average scores for emotional symptoms (0.85 ± 0.81 vs. 0.55 ± 1.03, P = 0.019), peer relationship problems (1.76 ± 2.23 vs. 0.76 ± 1.18, P = 0.001), and prosocial behavior (8.12 ± 1.87 vs. 7.42 ± 1.64, P = 0.002) in children with chronic functional constipation. Within the chronic constipation group, peer relationship issues were more common in boys, whereas girls exhibited more problems with prosocial behavior. Moreover, issues related to hyperactivity/inattention and prosocial behavior were more frequent in older children with chronic constipation. Conclusions: Chronic functional constipation in children is strongly associated with behavioral changes and problems, which are influenced by the demographic and anthropometric features of the patients.
{"title":"Assessment of Behavioral Disorders in Iranian Children with Functional Constipation","authors":"Armen Malekian Taghi, Niloufar Ghanbari, Safoura Rafiei, Hosein Shabani-Mirzaee, K. Eftekhari","doi":"10.5812/jcp-144576","DOIUrl":"https://doi.org/10.5812/jcp-144576","url":null,"abstract":"Background: Functional constipation (FC) is a common issue in pediatric healthcare, causing significant physical and emotional distress for patients and their families. Objectives: This study aimed to investigate the prevalence of behavioral issues in children diagnosed with functional constipation, exploring their characteristics and relationship with various factors. Methods: We conducted a case-control study involving 107 children and adolescents (aged 2 to 18 years) with chronic functional constipation as the case group and 107 children without this condition as the control group. The Strengths and Difficulties Questionnaire (SDQ) was employed to evaluate different aspects of behavioral patterns. Results: The comparison of various behavioral components assessed by the SDQ between the case and control groups revealed significantly higher average scores for emotional symptoms (0.85 ± 0.81 vs. 0.55 ± 1.03, P = 0.019), peer relationship problems (1.76 ± 2.23 vs. 0.76 ± 1.18, P = 0.001), and prosocial behavior (8.12 ± 1.87 vs. 7.42 ± 1.64, P = 0.002) in children with chronic functional constipation. Within the chronic constipation group, peer relationship issues were more common in boys, whereas girls exhibited more problems with prosocial behavior. Moreover, issues related to hyperactivity/inattention and prosocial behavior were more frequent in older children with chronic constipation. Conclusions: Chronic functional constipation in children is strongly associated with behavioral changes and problems, which are influenced by the demographic and anthropometric features of the patients.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"46 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140363845","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}
Nagwa Mohamed Sabry Mahmoud, Mostafa Ahmed El Sayed Ahmed Abu Elela, Marwa Ghallab Abdelghany, Moustafa Mohamad Abdel Raheem
Background: The 2019 global coronavirus pandemic is triggered by severe acute respiratory syndrome due to corona virus 2 (SARS-CoV-2). This infection can cause myocardial damage, arrhythmias, acute coronary syndrome, and venous thromboembolism. Objectives: The objective of this study is to provide a comprehensive description of the cardiac manifestations observed in children who have been admitted to the pediatric intensive care unit as a result of SARS-CoV-2 infection. Methods: The current prospective cross-sectional study included patients from Minia University Hospital's pediatric intensive care unit (PICU) isolation unit from April 2022 to April 2023. The study comprised 80 patients divided into two groups: Group I included 46 Corona Virus Induced Disease (COVID-19)-positive patients with cardiac complications. Group II consisted of 34 patients with COVID-19 infection but without cardiac complications. Results: The frequency of cardiac complications was 41.3% (33 children) with arrhythmias and 9% (3 children) with SVT by electrocardiography (ECG), whereas 31.3% of children had myocardial dysfunction (EF < 50%, FS < 25%) on echocardiography (ECHO). In comparison, 7.5% had bundle branch block (BBB). Conversely, 1.3% had pancarditis, and 3.8% had first-degree A-V block. Conclusions: More data is needed on COVID-19's cardiovascular effects on children. We found that acute COVID-19 hospitalized children should have cardiac exams and cardiovascular monitoring. COVID-19 infection in children often impairs systolic function, and arrhythmia may arise in COVID-19 individuals.
{"title":"Association Between SARS-CoV-2 Infection and Cardiovascular Disease in Children and Adolescents: A Cross-Sectional Study","authors":"Nagwa Mohamed Sabry Mahmoud, Mostafa Ahmed El Sayed Ahmed Abu Elela, Marwa Ghallab Abdelghany, Moustafa Mohamad Abdel Raheem","doi":"10.5812/jcp-140501","DOIUrl":"https://doi.org/10.5812/jcp-140501","url":null,"abstract":"Background: The 2019 global coronavirus pandemic is triggered by severe acute respiratory syndrome due to corona virus 2 (SARS-CoV-2). This infection can cause myocardial damage, arrhythmias, acute coronary syndrome, and venous thromboembolism. Objectives: The objective of this study is to provide a comprehensive description of the cardiac manifestations observed in children who have been admitted to the pediatric intensive care unit as a result of SARS-CoV-2 infection. Methods: The current prospective cross-sectional study included patients from Minia University Hospital's pediatric intensive care unit (PICU) isolation unit from April 2022 to April 2023. The study comprised 80 patients divided into two groups: Group I included 46 Corona Virus Induced Disease (COVID-19)-positive patients with cardiac complications. Group II consisted of 34 patients with COVID-19 infection but without cardiac complications. Results: The frequency of cardiac complications was 41.3% (33 children) with arrhythmias and 9% (3 children) with SVT by electrocardiography (ECG), whereas 31.3% of children had myocardial dysfunction (EF < 50%, FS < 25%) on echocardiography (ECHO). In comparison, 7.5% had bundle branch block (BBB). Conversely, 1.3% had pancarditis, and 3.8% had first-degree A-V block. Conclusions: More data is needed on COVID-19's cardiovascular effects on children. We found that acute COVID-19 hospitalized children should have cardiac exams and cardiovascular monitoring. COVID-19 infection in children often impairs systolic function, and arrhythmia may arise in COVID-19 individuals.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"48 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373219","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}
Mohammadreza Modaresi, Babak Rafizadeh, K. Eftekhari, R. Shirzadi, Fateme Tarighatmonfared, S. H. Mirlohi
Background: The Lung Clearance Index (LCI) serves as a non-uniform ventilation index utilized for monitoring pulmonary function in patients with cystic fibrosis (CF). Lung Clearance Index exhibits higher sensitivity compared to forced expiratory volume in 1 second (FEV1) for early detection of lung disease and does not necessitate active patient cooperation, as required for FEV1 measured through spirometry. Presently, FEV1 is the standard parameter employed for monitoring lung function in CF patients. Objectives: The objective of this study was to assess the correlation between LCI and FEV1 in patients with cystic fibrosis. Methods: This cross-sectional study enrolled children aged 6 to 18 years with confirmed CF diagnosis, who were referred to the CF clinic at Children's Medical Center Hospital (Tehran, Iran). Participants completed consent forms and subsequently underwent pulmonary function tests. Lung Clearance Index was calculated using the exhaling-D device via the Multiple Breath Washout (MBW) method, followed by FEV1 assessment through spirometry. Results: The study included 52 patients with an average age of 12 years, among whom 52% were males. The mean ± standard deviation of FEV1 and LCI were 80.2% ± 25.3 and 8.9 ± 2.8, respectively. A significant inverse relationship was observed between these two parameters in the study (r = -0.49, P = 0.001). Conclusions: These findings further underscore the potential utility of LCI, which offers ease of administration and demonstrates high reliability and accuracy compared to FEV1 for monitoring pulmonary function in CF patients.
{"title":"Correlation Between Lung Clearance Index (LCI) and Forced Expiratory Volume (FEV1) in Children with Cystic Fibrosis (CF): A Cross-Sectional Study","authors":"Mohammadreza Modaresi, Babak Rafizadeh, K. Eftekhari, R. Shirzadi, Fateme Tarighatmonfared, S. H. Mirlohi","doi":"10.5812/jcp-144672","DOIUrl":"https://doi.org/10.5812/jcp-144672","url":null,"abstract":"Background: The Lung Clearance Index (LCI) serves as a non-uniform ventilation index utilized for monitoring pulmonary function in patients with cystic fibrosis (CF). Lung Clearance Index exhibits higher sensitivity compared to forced expiratory volume in 1 second (FEV1) for early detection of lung disease and does not necessitate active patient cooperation, as required for FEV1 measured through spirometry. Presently, FEV1 is the standard parameter employed for monitoring lung function in CF patients. Objectives: The objective of this study was to assess the correlation between LCI and FEV1 in patients with cystic fibrosis. Methods: This cross-sectional study enrolled children aged 6 to 18 years with confirmed CF diagnosis, who were referred to the CF clinic at Children's Medical Center Hospital (Tehran, Iran). Participants completed consent forms and subsequently underwent pulmonary function tests. Lung Clearance Index was calculated using the exhaling-D device via the Multiple Breath Washout (MBW) method, followed by FEV1 assessment through spirometry. Results: The study included 52 patients with an average age of 12 years, among whom 52% were males. The mean ± standard deviation of FEV1 and LCI were 80.2% ± 25.3 and 8.9 ± 2.8, respectively. A significant inverse relationship was observed between these two parameters in the study (r = -0.49, P = 0.001). Conclusions: These findings further underscore the potential utility of LCI, which offers ease of administration and demonstrates high reliability and accuracy compared to FEV1 for monitoring pulmonary function in CF patients.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":" 871","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140382818","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}
Afshin Fayyazi, Maryam Shirmohamadi, A. Soltanian, H. Bazmamoun
Background: Migraine and functional constipation are prevalent chronic conditions among children, with many children suffering from migraines also experiencing functional constipation. Objectives: This study aims to investigate the impact of constipation treatment on headaches in children with migraines. Methods: This clinical trial involved 32 children aged 4 to 15 years, all diagnosed with both migraine and functional constipation. They were randomly divided into two groups: an intervention group and a control group, each comprising an equal number of participants. In the intervention group, both migraine and constipation were treated concurrently, whereas in the control group, only migraine was addressed. The outcomes of the two groups were then monitored and compared. Results: After the treatment, the intervention group experienced a significant reduction in the average number of monthly headache attacks (3 ± 2.4) compared to the control group (7.1 ± 6.9) with a P-value of 0.016. The average duration of each headache attack was shorter in the intervention group (2.3 ± 4.8 hours) compared to the control group (2.9 ± 4.2 hours), although this difference was not statistically significant. Parental satisfaction with the treatment was higher in the intervention group than in the control group, but this difference also lacked statistical significance. Constipation treatment was successful in all children in the study. Conclusions: The study's findings indicate that treating constipation in children with both migraine and functional constipation significantly reduces the frequency of headache attacks. However, it does not have a significant impact on the duration of headache attacks or on parental satisfaction with the treatment.
{"title":"Exploring the Impact of Treating Functional Constipation on Headache Episodes in Children Suffering from Migraine","authors":"Afshin Fayyazi, Maryam Shirmohamadi, A. Soltanian, H. Bazmamoun","doi":"10.5812/jcp-143088","DOIUrl":"https://doi.org/10.5812/jcp-143088","url":null,"abstract":"Background: Migraine and functional constipation are prevalent chronic conditions among children, with many children suffering from migraines also experiencing functional constipation. Objectives: This study aims to investigate the impact of constipation treatment on headaches in children with migraines. Methods: This clinical trial involved 32 children aged 4 to 15 years, all diagnosed with both migraine and functional constipation. They were randomly divided into two groups: an intervention group and a control group, each comprising an equal number of participants. In the intervention group, both migraine and constipation were treated concurrently, whereas in the control group, only migraine was addressed. The outcomes of the two groups were then monitored and compared. Results: After the treatment, the intervention group experienced a significant reduction in the average number of monthly headache attacks (3 ± 2.4) compared to the control group (7.1 ± 6.9) with a P-value of 0.016. The average duration of each headache attack was shorter in the intervention group (2.3 ± 4.8 hours) compared to the control group (2.9 ± 4.2 hours), although this difference was not statistically significant. Parental satisfaction with the treatment was higher in the intervention group than in the control group, but this difference also lacked statistical significance. Constipation treatment was successful in all children in the study. Conclusions: The study's findings indicate that treating constipation in children with both migraine and functional constipation significantly reduces the frequency of headache attacks. However, it does not have a significant impact on the duration of headache attacks or on parental satisfaction with the treatment.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"83 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140433509","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}
Context: Bardet-Biedl syndrome is a rare genetic disorder with variable prevalence rates across populations, characterized by symptoms such as retinal degeneration and intellectual disability. In this study, researchers investigated renal cystic epithelia from patients with PKD1 mutations. This study identified the upregulation of genes related to the Jak-STAT pathway and NF-κB signaling in these renal cells. These pathways appear to be crucial in regulating immune responses within cystic epithelial and renal cell types in PKD-affected kidneys. Evidence Acquisition: This study was carried out through a literature search with the keywords of polycystic kidney disease (PKD), Newborn, and Bardet-Biedl syndrome (BBS), combined with Drug Therapy in Scopes, PubMed, and Web of Science. This study included relevant articles (i.e., randomized controlled trials, observational studies, guidelines, and reviews) written in English and published between 2000 and 2023. Results: Recent genome-wide expression analyses have provided valuable insights into the molecular mechanisms associated with PKD. The Jak-STAT system, essential for immune signaling, can be activated by cytokines, such as interleukin 6 (IL-6) and interferon-gamma (IFN-γ). Conclusions: Promising developments in the treatment of PKD have emerged from studies involving immune-modulating drugs in animal models. Glucocorticoids and rosmarinic acid exhibited positive effects, reducing cystic indices and preserving renal function in PKD mice and rats. Mycophenolate mofetil, an immunosuppressive drug, showed effectiveness in reducing cyst area, inflammation, and fibrosis in rat models. Additionally, COX-2 inhibitors, PPARγ agonists, and vasopressin V2 receptor antagonists demonstrated potential in slowing cystic disease progression.
{"title":"Detection of Inflammatory Signaling in Individuals with Bardet-Biedl Syndrome Presenting Symptoms of Polycystic Kidney Disease","authors":"Mohammad Shiravi Khouzani, Krishnaveni Kandasamy","doi":"10.5812/jcp-140747","DOIUrl":"https://doi.org/10.5812/jcp-140747","url":null,"abstract":"Context: Bardet-Biedl syndrome is a rare genetic disorder with variable prevalence rates across populations, characterized by symptoms such as retinal degeneration and intellectual disability. In this study, researchers investigated renal cystic epithelia from patients with PKD1 mutations. This study identified the upregulation of genes related to the Jak-STAT pathway and NF-κB signaling in these renal cells. These pathways appear to be crucial in regulating immune responses within cystic epithelial and renal cell types in PKD-affected kidneys. Evidence Acquisition: This study was carried out through a literature search with the keywords of polycystic kidney disease (PKD), Newborn, and Bardet-Biedl syndrome (BBS), combined with Drug Therapy in Scopes, PubMed, and Web of Science. This study included relevant articles (i.e., randomized controlled trials, observational studies, guidelines, and reviews) written in English and published between 2000 and 2023. Results: Recent genome-wide expression analyses have provided valuable insights into the molecular mechanisms associated with PKD. The Jak-STAT system, essential for immune signaling, can be activated by cytokines, such as interleukin 6 (IL-6) and interferon-gamma (IFN-γ). Conclusions: Promising developments in the treatment of PKD have emerged from studies involving immune-modulating drugs in animal models. Glucocorticoids and rosmarinic acid exhibited positive effects, reducing cystic indices and preserving renal function in PKD mice and rats. Mycophenolate mofetil, an immunosuppressive drug, showed effectiveness in reducing cyst area, inflammation, and fibrosis in rat models. Additionally, COX-2 inhibitors, PPARγ agonists, and vasopressin V2 receptor antagonists demonstrated potential in slowing cystic disease progression.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435137","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}
Abdolreza Malek, Mohammadreza Abbaszadegan, Niloofar Vakili, Tina Zeraati, Ehsan Ghayoor Karimiani, Arian Sadrnabavi
Background: Familial Mediterranean fever (FMF) is an autosomal recessive disorder caused by a mutation in the MEFV gene and characterized by recurrent episodes of fever and polyserositis. Objectives: This study aimed to identify the frequency and distribution of MEFV mutations in children with FMF in northeastern Iran and determine clinical examinations. Methods: Our study was a descriptive and analytical cross-sectional study conducted among 29 patients under the age of 18 who visited the pediatric rheumatologist between April 2014 and 2021. After clinical diagnosis, the patients underwent genetic evaluation. The mutations related to each patient were identified using Sanger sequencing of the entire MEFV gene sequence. The rest of the information was extracted from the checklist. Finally, the data were analyzed using SPSS v. 16. Results: Fever was the most common symptom, followed by abdominal pain. During the acute attack period, laboratory inflammatory factors increased in all patients. None of the patients had complications. There was no significant relationship between the demographic variables in the groups (benign, variant of uncertain significance [VUS], pathogen) except for the rate of hospitalization (P-value = 0.039). Moreover, 34.5% of the studied patients had pathogenic mutations. The most common mutation was E148Q, which was reported to be benign, followed by pathogenic mutations (M680I), with a frequency of 10.2%. Conclusions: The FMF is rare in Northeastern Iran, and the number of pathogenic mutations is lower compared to Northwest Iran and other studies. It is necessary to conduct a genetic examination and treatment of affected patients to control the course of the disease and its complications.
{"title":"Genetic and Clinical Study of Children with Familial Mediterranean Fever in Northeastern Iran","authors":"Abdolreza Malek, Mohammadreza Abbaszadegan, Niloofar Vakili, Tina Zeraati, Ehsan Ghayoor Karimiani, Arian Sadrnabavi","doi":"10.5812/jcp-140025","DOIUrl":"https://doi.org/10.5812/jcp-140025","url":null,"abstract":"Background: Familial Mediterranean fever (FMF) is an autosomal recessive disorder caused by a mutation in the MEFV gene and characterized by recurrent episodes of fever and polyserositis. Objectives: This study aimed to identify the frequency and distribution of MEFV mutations in children with FMF in northeastern Iran and determine clinical examinations. Methods: Our study was a descriptive and analytical cross-sectional study conducted among 29 patients under the age of 18 who visited the pediatric rheumatologist between April 2014 and 2021. After clinical diagnosis, the patients underwent genetic evaluation. The mutations related to each patient were identified using Sanger sequencing of the entire MEFV gene sequence. The rest of the information was extracted from the checklist. Finally, the data were analyzed using SPSS v. 16. Results: Fever was the most common symptom, followed by abdominal pain. During the acute attack period, laboratory inflammatory factors increased in all patients. None of the patients had complications. There was no significant relationship between the demographic variables in the groups (benign, variant of uncertain significance [VUS], pathogen) except for the rate of hospitalization (P-value = 0.039). Moreover, 34.5% of the studied patients had pathogenic mutations. The most common mutation was E148Q, which was reported to be benign, followed by pathogenic mutations (M680I), with a frequency of 10.2%. Conclusions: The FMF is rare in Northeastern Iran, and the number of pathogenic mutations is lower compared to Northwest Iran and other studies. It is necessary to conduct a genetic examination and treatment of affected patients to control the course of the disease and its complications.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"27 9-10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140499633","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}
Background: Acute otitis media (AOM) is a common issue among children, often requiring antibiotic treatment. It is crucial to explore methods for the rational use of antibiotics. This study aimed to assess the effectiveness of the watchful waiting approach in treating children aged 6 months to 18 years with mild to moderate AOM. Methods: This prospective quasi-experimental study was conducted on 100 children with mild to moderate AOM. All patients, except those in severe or critical conditions, were placed on the watchful waiting strategy. A follow-up was conducted after 48 - 72 hours. If symptoms had improved, the watchful waiting approach continued. If medication was necessary for various reasons, these reasons were documented. Subsequently, children who completed the watchful waiting strategy were compared to those who received antibiotics. The collected data were analyzed using chi-square and t-tests in SPSS Statistics for Windows (version 16.0). Results: In this study, 59 patients (59%) were treated with the watchful waiting approach; nevertheless, 41 patients (41%) received antibiotics. The presence or absence of postnasal discharge showed a significant difference between the two groups (P = 0.001). No significant differences were observed between the two groups regarding fever (P = 0.066), enlarged tonsils (P = 0.740), snoring (P = 0.252), and bilateral involvement of the tympanic membrane (P = 0.313). Conclusions: Based on the results, the watchful waiting strategy is a cost-effective method for children aged over 6 months with mild to moderate symptoms, provided that parents cooperate fully. Clinicians should be cautious and consider alternative treatments if postnasal discharge is present, as it might indicate a higher likelihood of treatment failure with the watchful waiting approach.
{"title":"Watchful Waiting Strategy in the Treatment of Acute Otitis Media in Children","authors":"Mahnaz Haghighi","doi":"10.5812/jcp-141136","DOIUrl":"https://doi.org/10.5812/jcp-141136","url":null,"abstract":"Background: Acute otitis media (AOM) is a common issue among children, often requiring antibiotic treatment. It is crucial to explore methods for the rational use of antibiotics. This study aimed to assess the effectiveness of the watchful waiting approach in treating children aged 6 months to 18 years with mild to moderate AOM. Methods: This prospective quasi-experimental study was conducted on 100 children with mild to moderate AOM. All patients, except those in severe or critical conditions, were placed on the watchful waiting strategy. A follow-up was conducted after 48 - 72 hours. If symptoms had improved, the watchful waiting approach continued. If medication was necessary for various reasons, these reasons were documented. Subsequently, children who completed the watchful waiting strategy were compared to those who received antibiotics. The collected data were analyzed using chi-square and t-tests in SPSS Statistics for Windows (version 16.0). Results: In this study, 59 patients (59%) were treated with the watchful waiting approach; nevertheless, 41 patients (41%) received antibiotics. The presence or absence of postnasal discharge showed a significant difference between the two groups (P = 0.001). No significant differences were observed between the two groups regarding fever (P = 0.066), enlarged tonsils (P = 0.740), snoring (P = 0.252), and bilateral involvement of the tympanic membrane (P = 0.313). Conclusions: Based on the results, the watchful waiting strategy is a cost-effective method for children aged over 6 months with mild to moderate symptoms, provided that parents cooperate fully. Clinicians should be cautious and consider alternative treatments if postnasal discharge is present, as it might indicate a higher likelihood of treatment failure with the watchful waiting approach.","PeriodicalId":506036,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":"114 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139391120","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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