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False Negative Next-Generation-Sequencing Analysis in a Lipopolysa ccharide-Responsive Beige-Like Anchor Defect. 假阴性下一代测序分析中的一种脂多聚炭疽反应性米色样锚缺陷。
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23141
Tuğba Ünal, Saliha Esenboğa, Sevil Oskay Halaçlı, İlhan Tezcan, Deniz Çağdaş
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引用次数: 0
How Safe Are Biological Agents in Pediatric Rheumatology? 儿童风湿病学中的生物制剂有多安全?
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23221
Emine Nur Sunar Yayla, Çişem Yıldız, Pelin Esmeray Şenol, Nihal Karaçayır, Deniz Gezgin Yıldırım, Sevcan A Bakkaloğlu

Objective: Biologic therapy has changed the prognosis of patients with rheumatologic disease. Despite all benefits of the biological agents, adverse events may occur due to their long-term use. The aim of this study is to analyze the adverse events observed in pediatric patients who received biological treatment.

Materials and methods: This retrospective observational cohort study was conducted between January 2010 and January 2022. File records of 139 patients used biological agents for rheumatologic diseases in a pediatric rheumatology clinic were evaluated. Diagnosis, received treatment, the rationale for stopping treatment, requirement of tuberculosis prophylaxis, presence of an adverse event, and results were recorded.

Results: The most used biological therapy was etanercept (41.7%). Anakinra, adalimumab, canakinumab were used in 30.9%, 27.3%, 23.7% of patients, and the others in less than 10%. Totally 491 adverse events (97.9/100 patient-years) were encountered during the duration of biological treatment. The most often adverse event was recurrent upper respiratory tract infection in the patients (31.9/100 patient-years). Elevated aminotransferase levels (10.4/100 patient-years), abdominal pain (7/100 patient-years), and headache (5.2/100 patient-years) were among the other common side effects. Isoniazid (INH) prophylaxis was needed before biological treatment in 20.9% of the patients. Tuberculosis developed in none of the patients followed-up for latent tuberculosis, however, it developed in a patient while receiving etanercept due to noncompliance with his scheduled outpatient visits during etanercept treatment.

Conclusion: The most commonly used biological treatments were TNFi and IL-antagonists, and the majority of side effects were infections and laboratory abnormalities. Although the rate of serious adverse events is quite low, close follow-up of patients receiving biological therapy is very important.

目的:生物疗法改变了风湿病患者的预后:生物疗法改变了风湿病患者的预后。尽管生物制剂有诸多益处,但长期使用可能会出现不良反应。本研究旨在分析在接受生物制剂治疗的儿童患者中观察到的不良事件:这项回顾性观察队列研究在 2010 年 1 月至 2022 年 1 月期间进行。研究评估了儿科风湿病诊所中使用生物制剂治疗风湿病的 139 名患者的档案记录。研究记录了诊断、接受的治疗、停止治疗的理由、预防结核病的要求、不良事件的发生以及治疗结果:结果:最常用的生物疗法是依那西普(etanercept,41.7%)。30.9%、27.3%和23.7%的患者使用了阿纳金拉、阿达木单抗和卡纳库单抗,其他药物的使用率低于10%。在生物治疗期间,共发生了 491 例不良事件(97.9/100 患者年)。最常见的不良反应是患者反复出现上呼吸道感染(31.9/100 患者年)。其他常见的副作用包括转氨酶水平升高(10.4/100 病人年)、腹痛(7/100 病人年)和头痛(5.2/100 病人年)。20.9%的患者在接受生物治疗前需要进行异烟肼(INH)预防。在因潜伏肺结核而接受随访的患者中,没有人出现肺结核,但有一名患者在接受依那西普治疗期间,因未遵守依那西普治疗期间的门诊安排而出现肺结核:结论:最常用的生物治疗方法是 TNFi 和 IL-拮抗剂,副作用主要是感染和实验室异常。虽然严重不良事件的发生率很低,但对接受生物疗法的患者进行密切随访非常重要。
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引用次数: 0
A Tale of a Trail on How It Takes 5 Days of Kawasaki Disease to Initiate Coronary Artery Injury and Change the Lives of Children. 一个关于川崎病如何在 5 天内引发冠状动脉损伤并改变儿童生命的小径故事。
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23254
Nigah Dahdah

Many articles written on Kawasaki disease explain the disease and the history of an acute inflammatory dysregulation that typically affects preschool children and does not spare older ones. Six decades have passed since the discovery of the disease in Japan, yet there are parts of the world where the disease passes unacknowledged, diagnosis is delayed, or basic treatments are not readily available. The burden of Kawasaki disease is on every health-care provider who attends to children's health. It takes 5 days for the disease to initiate coronary artery injury in a child's heart, compared to 5 decades of lifetime atherosclerosis. Challenges facing patients, families, and physicians may not be overcome unless we advocate for the disease recognition and seek support for affordable, timely treatment, impactful research, and dissemination of knowledge. The purpose of this review is to provide a comprehensive review of the history of Kawasaki disease and how it has affected children's health worldwide over the last 6 decades. The review also raises current challenges facing the fight against Kawasaki disease. In an effort to bring Kawasaki disease advocates together in a landing zone, an internet hub for Kawasaki disease experts and enthusiasts has been created: the International Kawasaki Disease Society (presently a concept idea) and a dedicated website, www.ikds-org.

许多关于川崎病的文章都解释了这种疾病以及急性炎症失调的历史,这种疾病通常会影响学龄前儿童,也不会放过年龄较大的儿童。自日本发现川崎病以来,60 年过去了,但世界上仍有一些地方的川崎病不为人知,诊断被延误,或无法获得基本治疗。川崎病给每一位关注儿童健康的医护人员带来了沉重的负担。川崎病只需 5 天就能造成儿童心脏冠状动脉损伤,而一生中动脉粥样硬化的时间则长达 50 年。除非我们倡导对该疾病的认识,并为负担得起的及时治疗、有影响力的研究和知识传播寻求支持,否则患者、家属和医生面临的挑战可能无法克服。本综述旨在全面回顾川崎病的历史及其在过去 60 年中如何影响全球儿童的健康。本综述还提出了当前抗击川崎病所面临的挑战。为了将川崎病的拥护者聚集在一个着陆区,我们创建了一个川崎病专家和爱好者的互联网中心:国际川崎病协会(目前只是一个概念)和一个专门的网站 www.ikds-org。
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引用次数: 0
An Unexpected Diagnosis of The Rectal Polyp: Perivascular Epithelioid Cell Tumor. 直肠息肉的意外诊断:血管周围上皮样细胞瘤
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23261
Muhammed Hamidullah Çakmak, Nevzat Aykut Bayrak, Şermin Kökten, Aslı Turgutoğlu Yılmaz, Sümeyra Oğuz, Serdar Moralıoğlu
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引用次数: 0
Artificial Intelligence in Pediatrics: Learning to Walk Together. 儿科人工智能:学会携手同行
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.24002
Kaan Can Demirbaş, Mehmet Yıldız, Seha Saygılı, Nur Canpolat, Özgür Kasapçopur

In this era of rapidly advancing technology, artificial intelligence (AI) has emerged as a transformative force, even being called the Fourth Industrial Revolution, along with gene editing and robotics. While it has undoubtedly become an increasingly important part of our daily lives, it must be recognized that it is not an additional tool, but rather a complex concept that poses a variety of challenges. AI, with considerable potential, has found its place in both medical care and clinical research. Within the vast field of pediatrics, it stands out as a particularly promising advancement. As pediatricians, we are indeed witnessing the impactful integration of AI-based applications into our daily clinical practice and research efforts. These tools are being used for simple to more complex tasks such as diagnosing clinically challenging conditions, predicting disease outcomes, creating treatment plans, educating both patients and healthcare professionals, and generating accurate medical records or scientific papers. In conclusion, the multifaceted applications of AI in pediatrics will increase efficiency and improve the quality of healthcare and research. However, there are certain risks and threats accompanying this advancement including the biases that may contribute to health disparities and, inaccuracies. Therefore, it is crucial to recognize and address the technical, ethical, and legal challenges as well as explore the benefits in both clinical and research fields.

在这个科技飞速发展的时代,人工智能(AI)已成为一股变革力量,甚至与基因编辑和机器人技术并称为第四次工业革命。毫无疑问,人工智能已成为我们日常生活中越来越重要的一部分,但我们必须认识到,人工智能并不是一个额外的工具,而是一个复杂的概念,它带来了各种挑战。人工智能潜力巨大,已在医疗保健和临床研究领域占据一席之地。在广阔的儿科领域,人工智能的发展前景尤为广阔。作为儿科医生,我们确实见证了人工智能应用对我们日常临床实践和研究工作的影响。这些工具被用于从简单到更复杂的任务,如诊断具有临床挑战性的病症、预测疾病结果、制定治疗计划、教育患者和医疗保健专业人员,以及生成准确的医疗记录或科学论文。总之,人工智能在儿科领域的多方面应用将提高医疗保健和研究的效率和质量。然而,这一进步也伴随着一定的风险和威胁,包括可能导致健康差异和不准确的偏见。因此,认识和应对技术、伦理和法律方面的挑战以及探索临床和研究领域的益处至关重要。
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引用次数: 0
Evaluation of Hepatosteatosis-Induced Increase in Fibrosity by Two-Dimensional Shear Wave Elastography in Children with Obesity and Comparison with Healthy Peers. 通过二维剪切波弹性成像评估肥胖症儿童肝硬化引起的纤维性增加并与健康儿童进行比较
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23237
Hanife Gülden Düzkalır, Elif Söbü, Ömer Aydıner

Objective: The increase in the prevalence of obesity, nonalcoholic fatty liver disease (NAFLD), and related comorbidities in children creates a social and financial burden. In our study, we aimed to evaluate liver findings together with anthropometric and laboratory data with twodimensional shear wave elastography (2D-SWE), one of the SWE types, which is a noninvasive method for assessing tissue stiffness in children with obesity, and to obtain quantitative data that can be used in early diagnosis and follow-up.

Materials and methods: In our single-center, observational cross-sectional study, liver gray scale findings, 2D-SWE findings, anthropometric measurements, and laboratory values of 48 children with obesity and 50 healthy children aged between 5 and 18 years, both between groups and in prepubertal and pubertal subgroups, are compared.

Results: A significant difference was found in the liver stiffness indicator kilopascal (kPA) values and between aspartate aminotransferase values in the prepubertal period and alanine aminotransferase values in the pubertal period (P < .001). No significant difference was found between insulin, HOMA-IR, waist circumference, waist/height ratio, and kPA.

Conclusion: Two-dimensional shear wave elastography can be easily applied in the pediatric population as a practical, noninvasive, reproducible, and highly compatible technique. In this regard, 2D-SWE may be useful in the early diagnosis and follow-up of hepatosteatosis and fibrosis in children with obesity and NAFLD-risky cases.

目的:儿童肥胖症、非酒精性脂肪肝(NAFLD)及相关并发症发病率的上升造成了社会和经济负担。在我们的研究中,我们旨在通过二维剪切波弹性成像(2D-SWE)评估肝脏检查结果以及人体测量和实验室数据,二维剪切波弹性成像是 SWE 的一种类型,是评估肥胖症儿童组织僵硬度的一种无创方法,并获得可用于早期诊断和随访的定量数据:在我们的单中心观察性横断面研究中,比较了 48 名肥胖症儿童和 50 名 5 至 18 岁健康儿童的肝脏灰度结果、二维-SWE 结果、人体测量和实验室值,包括组间、青春期前和青春期亚组:结果:发现肝脏硬度指标千帕斯卡(kPA)值以及青春期前的天冬氨酸氨基转移酶值和青春期后的丙氨酸氨基转移酶值之间存在明显差异(P < .001)。胰岛素、HOMA-IR、腰围、腰围/身高比和 kPA 之间无明显差异:二维剪切波弹性成像技术作为一种实用、无创、可重复和高度兼容的技术,可轻松应用于儿科人群。因此,二维剪切波弹性成像可用于肥胖症和非酒精性脂肪肝高危病例儿童肝脂肪变性和肝纤维化的早期诊断和随访。
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引用次数: 0
A 9-Year-Old Female with an Abdominal Mass. 一名 9 岁女性的腹部肿块。
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.24025
Justin E Anderson, Don Walker, Farnaz Norozian, Kristina Domanski
{"title":"A 9-Year-Old Female with an Abdominal Mass.","authors":"Justin E Anderson, Don Walker, Farnaz Norozian, Kristina Domanski","doi":"10.5152/TurkArchPediatr.2024.24025","DOIUrl":"10.5152/TurkArchPediatr.2024.24025","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"59 2","pages":"232-233"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11059311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paediatrics and Child Health Need a United, Credible and Strong Pan-European Voice. 儿科和儿童健康需要一个统一、可信和强有力的泛欧声音。
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.242102
Berthold Koletzko
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引用次数: 0
Switching from Deferasirox Dispersible Tablets to Deferasirox Film-Coated Tablets: Is There an Effect on Ferritin Levels in Children and Adolescents with Transfusion-Dependent Anemia? 从地拉罗司分散片转为地拉罗司薄膜衣片:对输血依赖性贫血儿童和青少年的铁蛋白水平有影响吗?
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23262
Esra Arslantaş, Ali Ayçiçek, Sibel Akpınar Tekgündüz, Duygu Özkorucu Yıldırgan, Ayşe Özkan Karagenç, Tuba Nur Tahtakesen Güçer, Ayşe Gonca Kaçar, Cengiz Bayram, Nihal Özdemir

Objective: To investigate the effect of switching from deferasirox dispersible tablet (DT) to deferasirox film-coated tablet (FCT) on serum ferritin (SF) levels in transfusion-dependent patients.

Materials and methods: Patients who received regular erythrocyte transfusion and whose treatment was switched from DT to FCT were included in the study. FCT start date was taken as the index date. Patients were followed over 2 equal and long periods, both before and after index date.

Results: Thirty-two patients were included, and the comparison periods ranged from 4 to 12 months. The SF values increased from a median of 1723 ng/mL (range 717-5369 ng/mL) to 1.853 ng/mL (range 924-5478 ng/mL) after switching from DT to FCT (P = .036). While there was a significant increase in median SF after switching in Turkish patients (1467 ng/mL to 1778 ng/ mL, P = .010) and patients ≥12 years (1598-1848 ng/mL, P = .009), there was an insignificant (P = .859) decrease in SF in immigrant children. Considering only the post-switch period, there was a non-significant increase in median SF in the entire cohort, while SF decreased significantly in immigrant children (P = .026). No serious side effects were observed in any patient that would cause discontinuation of treatment.

Conclusion: Overall, higher SF value was observed with FCT compared to DT in short term. There were different results between patient groups. Our results suggest that FCT is more effective than DT in patients with high basal ferritin and who are actually incompatible with treatment and should be preferred first in these patients.

目的研究从地拉羅司分散片(DT)转为地拉羅司薄膜衣片(FCT)对输血依赖患者血清铁蛋白(SF)水平的影响:研究对象包括定期接受红细胞输注且治疗方法从 DT 转为 FCT 的患者。以 FCT 开始日期为指标日期。在指标日期之前和之后,对患者进行了两次等长的随访:研究共纳入 32 名患者,比较期从 4 个月到 12 个月不等。从 DT 转为 FCT 后,SF 值从中位数 1723 纳克/毫升(范围 717-5369 纳克/毫升)增至 1.853 纳克/毫升(范围 924-5478 纳克/毫升)(P = .036)。土耳其患者(1467 纳克/毫升至 1778 纳克/毫升,P = .010)和年龄≥12 岁的患者(1598-1848 纳克/毫升,P = .009)的中位数 SF 在转换后有明显增加,而移民儿童的 SF 下降不明显(P = .859)。仅考虑转换后时期,整个队列的 SF 中位数增加不显著,而移民儿童的 SF 显著下降(P = .026)。没有观察到任何患者出现严重的副作用而导致中断治疗:结论:总体而言,在短期内,FCT 的 SF 值高于 DT。结论:总体而言,在短期内,FCT 的 SF 值高于 DT。我们的研究结果表明,对于基础铁蛋白较高且实际上不适合治疗的患者,FCT 比 DT 更有效,因此应优先考虑这些患者。
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引用次数: 0
The Frequency, Severity, and Risk Factors of Hickman CatheterRelated Complications in Pediatric Cancer Patients: A Single-Center Experience from Bosnia and Herzegovina. 小儿癌症患者希克曼导管相关并发症的频率、严重程度和风险因素:来自波斯尼亚和黑塞哥维那的单中心经验。
Q3 PEDIATRICS Pub Date : 2024-03-01 DOI: 10.5152/TurkArchPediatr.2024.23179
Zlatan Zvizdic, Emin Zaimovic, Emir Milisic, Asmir Jonuzi, Una Glamoclija, Semir Vranic

Objective: This study aimed to identify the frequency, severity, and risk factors associated with Hickman catheter-related complications in children with hemato-oncological malignancies at the largest pediatric tertiary care unit in Bosnia and Herzegovina.

Materials and methods: A cross-sectional study was conducted on a cohort of pediatric cancer patients who underwent Hickman central venous catheters (CVCs) between January 2019 and December 2022. Mechanical, infectious, and thrombotic Hickman catheter-related complications were evaluated and analyzed. We also investigated possible risk factors associated with these complications.

Results: Seventy-one Hickman CVCs were inserted in 68 children (44 boys and 24 girls) at a mean age of 6.9 ± 4.6. Forty (58.8%) children had hematological malignancies and 28 (41.2%) solid cancers. The median follow-up after Hickman CVC insertion was 190 days (95% CI [160-212]) for 12 644 catheter days. During follow-up, 10 (14.1%) mechanical, 7 (9.9%) infectious, and 1 (1.4%) thrombotic complications were recorded (0.8, 0.48, and 0.08 for mechanical, infectious, and thrombotic complications per 1000 catheter days, respectively). A slightly higher incidence of complications was recorded in children with hematological malignancies (1.59 per 1000 catheter days) compared with children with solid cancers (1.22 complications per 1000 catheter days).

Conclusion: Using Hickman CVCs for long-term venous access in infusional chemotherapy for pediatric cancer patients is safe but is associated with significant morbidity.

研究目的本研究旨在确定波斯尼亚和黑塞哥维那最大的儿科三级医疗单位中血液肿瘤恶性肿瘤患儿出现希克曼导管相关并发症的频率、严重程度和相关风险因素:对2019年1月至2022年12月期间接受希克曼中心静脉导管(CVC)治疗的一组儿科癌症患者进行了横断面研究。对机械性、感染性和血栓性希克曼导管相关并发症进行了评估和分析。我们还调查了与这些并发症相关的可能风险因素:68名平均年龄为6.9 ± 4.6岁的儿童(44名男孩和24名女孩)接受了71例希克曼导管插入手术。40名儿童(58.8%)患有血液系统恶性肿瘤,28名儿童(41.2%)患有实体瘤。插入希克曼CVC后的随访中位数为190天(95% CI [160-212]),导管使用天数为12 644天。在随访期间,共记录到 10 例(14.1%)机械性并发症、7 例(9.9%)感染性并发症和 1 例(1.4%)血栓性并发症(每 1000 个导管日的机械性、感染性和血栓性并发症发生率分别为 0.8、0.48 和 0.08)。血液恶性肿瘤患儿的并发症发生率(每1000导管日1.59例)略高于实体瘤患儿(每1000导管日1.22例):结论:在小儿癌症患者的输液化疗中使用 Hickman CVC 进行长期静脉通路是安全的,但会导致严重的发病率。
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引用次数: 0
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Turkish archives of pediatrics
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