Pub Date : 2021-09-07DOI: 10.26650/jchild.2021.925276
G. Babuna Kobaner, E. Özkaya
Amac: Fiks ilac erupsiyonu (FIE), sik gorulen ve her yasi etkileyebilen bir ilac dokuntusu olmasina ragmen cocuklarda nadiren bildirilmistir. Calismamizda, Turkiye’de ucuncu basamak bir referans merkezde FIE tanisi konulmus olan pediatrik hastalarin karakteristik ozelliklerinin degerlendirilmesi amaclanmistir. Gerec ve Yontem: Bu tek-merkezli, retrospektif kohort calismasi, klinigimizde 1996-2019 yillari arasinda FIE tanisi konularak takip ve tedavi edilen cocuk hastalarin, standart olarak hazirlanmis hasta takip formlarindaki verilerinin analiz edilmesiyle gerceklestirilmistir. Bulgular: Calismamizda pediatrik FIE’nin genel prevalansi %10,4 (n=22/212) olarak bulundu. Cocuklarda FIE’nin en sik nedeni 2003 yilindan once kotrimoksazol iken daha sonraki yillarda non-steroidal antienflamatuvar ilaclar (ozellikle naproksen) on plandaydi. Ates dusurucu supozituvarlar icinde bulunan fenobarbital de ozellikle kucuk cocuklarda FIE’nin bir diger onemli nedeniydi. Cocuklarda en cok tutulan alanlar sirasiyla govde (%68,2), dudaklar (%54,5) ve ekstremiteler (%45,5) olarak bulundu. Hemen her bolgede FIE’nin en sik nedeni kotrimoksazol iken, perioral bolgede fenobarbitaldi. Cocuklarin %36,4’unde oral mukoza tutulumu goruldu. Oral mukoza lezyonlari genellikle multiple olup ic dudak mukozasini tutmaktaydi (%75,0) ve en sik gorulen morfolojik formu bulloz/erozif (50,0%) idi. Cocuklarda genital mukoza tutulumuna daha nadir (%31,8) rastlandi. Kotrimoksazole-bagli FIE’si olan ve HLA tiplendirilmesi yapilan 9 cocuktan 5’inde (%55,6) komplet haplotip (HLA-A30 B13 Cw6) veya tek basina antijen (HLA-A30 veya HLA-Cw6) pozitiflikleri saptandi. Bu bulgu, kotrimoksazole bagli FIE ile HLA-A30 arasinda potansiyel bir iliski oldugunu destekler nitelikteydi. Sonuc: Calismamiz, FIE’nin pediatrik yas grubunda sik gorulen bir ilac erupsiyonu oldugunu ortaya koymustur. Ayrica, cocuklarda gorulen FIE’nin, klinik bulgular, ilaca-spesifik bolge tutulumu ve en sik neden olan ilaclar acisindan eriskinlerde gorulen FIE’ye buyuk olcude benzerlik gosterdigi saptanmistir
{"title":"Fixed Drug Eruption in Children: a 24-Year, Single-center, Retrospective Cohort Study from Turkey","authors":"G. Babuna Kobaner, E. Özkaya","doi":"10.26650/jchild.2021.925276","DOIUrl":"https://doi.org/10.26650/jchild.2021.925276","url":null,"abstract":"Amac: Fiks ilac erupsiyonu (FIE), sik gorulen ve her yasi etkileyebilen bir ilac dokuntusu olmasina ragmen cocuklarda nadiren bildirilmistir. Calismamizda, Turkiye’de ucuncu basamak bir referans merkezde FIE tanisi konulmus olan pediatrik hastalarin karakteristik ozelliklerinin degerlendirilmesi amaclanmistir. Gerec ve Yontem: Bu tek-merkezli, retrospektif kohort calismasi, klinigimizde 1996-2019 yillari arasinda FIE tanisi konularak takip ve tedavi edi\u0002len cocuk hastalarin, standart olarak hazirlanmis hasta takip formlarindaki verilerinin analiz edilmesiyle gerceklestirilmistir. Bulgular: Calismamizda pediatrik FIE’nin genel prevalansi %10,4 (n=22/212) olarak bulundu. Cocuklarda FIE’nin en sik nedeni 2003 yilindan once kotrimoksazol iken daha sonraki yillarda non-steroidal antienflamatuvar ilaclar (ozellikle naproksen) on plandaydi. Ates dusurucu supozituvarlar icinde bulunan fenobarbital de ozellikle kucuk cocuklarda FIE’nin bir diger onemli nedeniydi. Cocuklarda en cok tutulan alanlar sirasiyla govde (%68,2), dudaklar (%54,5) ve ekstremiteler (%45,5) olarak bulundu. Hemen her bolgede FIE’nin en sik nedeni kotrimoksazol iken, perioral bolgede fenobarbitaldi. Cocuklarin %36,4’unde oral mukoza tutulumu goruldu. Oral mukoza lezyonlari genellikle multiple olup ic dudak mukozasini tutmaktaydi (%75,0) ve en sik gorulen morfolojik formu bulloz/erozif (50,0%) idi. Cocuklarda genital mukoza tutulumuna daha nadir (%31,8) rastlandi. Kotrimoksazole-bagli FIE’si olan ve HLA tiplendirilmesi yapilan 9 cocuktan 5’inde (%55,6) komplet haplotip (HLA-A30 B13 Cw6) veya tek basina antijen (HLA-A30 veya HLA-Cw6) pozitiflikleri saptandi. Bu bulgu, kotrimoksazole bagli FIE ile HLA-A30 arasinda potansiyel bir iliski oldugunu destekler nitelikteydi. Sonuc: Calismamiz, FIE’nin pediatrik yas grubunda sik gorulen bir ilac erupsiyonu oldugunu ortaya koymustur. Ayrica, cocuklarda gorulen FIE’nin, klinik bulgular, ilaca-spesifik bolge tutulumu ve en sik neden olan ilaclar acisindan eriskinlerde gorulen FIE’ye buyuk olcude benzerlik gosterdigi saptanmistir","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88407697","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 : 2020-12-28DOI: 10.26650/jchild.2020.3.768460
Muhammet Fatih Sebirli, Gülçin Canbeyli, Nalan Karabayır
Breastfeeding has numerous health benefits for both the mother and the baby. Apart from mothers wanting the best for their babies, breastfeeding symbolizes motherhood in the society. Thus, mothers are urged to breastfeed. In addition, breastfeeding has a positive effect on the motherbaby bond, which also encourages adoptive mothers to breastfeed. Breastfeeding is achieved with induced lactation in adoptive mothers. In this article, the application of a mother who adopted a 10-week-old baby to the breastfeeding outpatient clinic for breastfeeding support was evaluated. Domperidone was started for the mother who had no pregnancy or breastfeeding history. Consequently, skin contact, milking every 3 h, and formula feeding with the finger-feeding method were recommended. The mother, who started milk secretion 1 week later and continued milking, stated that the baby started sucking while sleeping. Thus, the requirement for formula milk decreased. On the 45th day of the process, skin contact, regular milking, and use of domperidone were recommended to the mother whose milk decreased after domperidone cessation. Conversely, the baby whose mother did not use domperidone was also supported with complementary feeding because the baby refused to suck. The mother’s milk secretion stopped after 1 month, and continued pumping was recommended. It was found that the mother breastfed her 20-month-old baby for 5 months. In this case report, a mother with no pregnancy and breastfeeding history was able to feed her baby with breast milk. The baby’s age being younger than 3 months and the mothers’ strong motivation and being closely monitored and supported are few of the most important factors in being successful with the process of induced lactation. Thus, health professionals having information about induced lactation and relactation are integral in starting and continuing with the process.
{"title":"Evlat Edindim, Emzirmek İstiyorum: Olgu Sunumu","authors":"Muhammet Fatih Sebirli, Gülçin Canbeyli, Nalan Karabayır","doi":"10.26650/jchild.2020.3.768460","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.768460","url":null,"abstract":"Breastfeeding has numerous health benefits for both the mother and the baby. Apart from mothers wanting the best for their babies, breastfeeding symbolizes motherhood in the society. Thus, mothers are urged to breastfeed. In addition, breastfeeding has a positive effect on the motherbaby bond, which also encourages adoptive mothers to breastfeed. Breastfeeding is achieved with induced lactation in adoptive mothers. In this article, the application of a mother who adopted a 10-week-old baby to the breastfeeding outpatient clinic for breastfeeding support was evaluated. Domperidone was started for the mother who had no pregnancy or breastfeeding history. Consequently, skin contact, milking every 3 h, and formula feeding with the finger-feeding method were recommended. The mother, who started milk secretion 1 week later and continued milking, stated that the baby started sucking while sleeping. Thus, the requirement for formula milk decreased. On the 45th day of the process, skin contact, regular milking, and use of domperidone were recommended to the mother whose milk decreased after domperidone cessation. Conversely, the baby whose mother did not use domperidone was also supported with complementary feeding because the baby refused to suck. The mother’s milk secretion stopped after 1 month, and continued pumping was recommended. It was found that the mother breastfed her 20-month-old baby for 5 months. In this case report, a mother with no pregnancy and breastfeeding history was able to feed her baby with breast milk. The baby’s age being younger than 3 months and the mothers’ strong motivation and being closely monitored and supported are few of the most important factors in being successful with the process of induced lactation. Thus, health professionals having information about induced lactation and relactation are integral in starting and continuing with the process.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"37 Suppl 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78330042","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 : 2020-12-28DOI: 10.26650/jchild.2020.3.807529
A. Taktak, Neslihan Çiçek
Objective: Idiopathic nephrotic syndrome (INS) is the most common glomerular disease in children. Approximately 80% of INS is steroid sensitive (SSNS), and half of SSNS patients are steroid dependent (SDNS). This study determines the risk factors that may predict steroid dependence in patients with SSNS. Material and Method: Patients with SSNS who followed in our Pediatric Nephrology clinic between September 2016 and September 2018 were retrospectively evaluated. The demographic characteristics, albumin, creatinine values, blood pressure, white blood cell, lymphocyte count, lymphocyte/white blood cell ratio, urine protein–creatinine ratio, time to remission, and triggers of the attack were recorded. Results: Twenty-three patients were diagnosed as SSNS and 16 as SDNS. The mean age at presentation was 77.34±32 months in the SSNS group and 73.62±27.32 months in the SDNS group (p=0.690). No significant difference was observed between the two groups in terms of blood albumin, creatinine, lymphocyte count, and lymphocyte/white blood cell ratio. Trigger initiating the attack was more common in the SDNS group (p=0.001). The most common trigger was upper respiratory tract infection. Urine protein/creatinine ratio and white blood cell levels were significantly higher in the SDNS group (p=0.014, p=0.004, respectively), and the time to remission was also longer in the SDNS group (p=0.001). Conclusion: Upper respiratory tract infection may be a trigger, and severe proteinuria and late remission time may be risk factors for the development of SDNS in INS. Early use of steroid-sparing agents in these patients can prevent long-term adverse effects of steroid therapy.
{"title":"İdiyopatik Nefrotik Sendromda İlk Atakta Steroid Bağımlılığı Öngörülebilir mi?","authors":"A. Taktak, Neslihan Çiçek","doi":"10.26650/jchild.2020.3.807529","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.807529","url":null,"abstract":"Objective: Idiopathic nephrotic syndrome (INS) is the most common glomerular disease in children. Approximately 80% of INS is steroid sensitive (SSNS), and half of SSNS patients are steroid dependent (SDNS). This study determines the risk factors that may predict steroid dependence in patients with SSNS. Material and Method: Patients with SSNS who followed in our Pediatric Nephrology clinic between September 2016 and September 2018 were retrospectively evaluated. The demographic characteristics, albumin, creatinine values, blood pressure, white blood cell, lymphocyte count, lymphocyte/white blood cell ratio, urine protein–creatinine ratio, time to remission, and triggers of the attack were recorded. Results: Twenty-three patients were diagnosed as SSNS and 16 as SDNS. The mean age at presentation was 77.34±32 months in the SSNS group and 73.62±27.32 months in the SDNS group (p=0.690). No significant difference was observed between the two groups in terms of blood albumin, creatinine, lymphocyte count, and lymphocyte/white blood cell ratio. Trigger initiating the attack was more common in the SDNS group (p=0.001). The most common trigger was upper respiratory tract infection. Urine protein/creatinine ratio and white blood cell levels were significantly higher in the SDNS group (p=0.014, p=0.004, respectively), and the time to remission was also longer in the SDNS group (p=0.001). Conclusion: Upper respiratory tract infection may be a trigger, and severe proteinuria and late remission time may be risk factors for the development of SDNS in INS. Early use of steroid-sparing agents in these patients can prevent long-term adverse effects of steroid therapy.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86276342","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}
Uzun süreli kalıcı kateter kullanımının en önemli komplikasyonu kateter enfeksiyonlarıdır. Infectious Diseases Society of America (IDSA) koagülaz negatif stafilokok, S.aureus ve gram (-) ilişkili kateter enfeksiyonlarında kateter değişimi mümkün değilse sistemik tedavi ve kateter kilit tedavisinin birlikte verilmesini; fungal enfeksiyonlarda ise kateterin değişimini önermektedir. Ancak kısa barsak sendromu, konjenital diare bozuklukları gibi özel hasta gruplarında Candida ilişkili kateter enfeksiyonları sık görülmektedir. Bu durum sürekli kateter değişimleri ve komplikasyonlarına neden olmakta, hastanelerde büyük maliyet kaybı oluşturmaktadır. Burada NEUROG3 gen defekti, konjenital intestinal malabsorbsiyon sendromu tanılı yaşamını parenteral nutrisyon ile idame ettiren iki yıl dokuz aylık kız hastada liposomal amfoterisin B kilit ve sistemik tedavisi uygulanarak C. glabrata ilişkili kateter enfeksiyonunun tedavi edildiği başarılı bir olgu sunulmuştur.
{"title":"Kateter Enfeksiyonlarına Alternatif Çözüm: Kilit Tedavisi","authors":"Ayşenur Kardaş, Nazan Dalgıç, Dilek Güller, Sibel Değim İlgar, Banu Bayraktar, Ömer Naci Tabakçı","doi":"10.26650/jchild.2020.3.772803","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.772803","url":null,"abstract":"Uzun süreli kalıcı kateter kullanımının en önemli komplikasyonu kateter enfeksiyonlarıdır. Infectious Diseases Society of America (IDSA) koagülaz negatif stafilokok, S.aureus ve gram (-) ilişkili kateter enfeksiyonlarında kateter değişimi mümkün değilse sistemik tedavi ve kateter kilit tedavisinin birlikte verilmesini; fungal enfeksiyonlarda ise kateterin değişimini önermektedir. Ancak kısa barsak sendromu, konjenital diare bozuklukları gibi özel hasta gruplarında Candida ilişkili kateter enfeksiyonları sık görülmektedir. Bu durum sürekli kateter değişimleri ve komplikasyonlarına neden olmakta, hastanelerde büyük maliyet kaybı oluşturmaktadır. Burada NEUROG3 gen defekti, konjenital intestinal malabsorbsiyon sendromu tanılı yaşamını parenteral nutrisyon ile idame ettiren iki yıl dokuz aylık kız hastada liposomal amfoterisin B kilit ve sistemik tedavisi uygulanarak C. glabrata ilişkili kateter enfeksiyonunun tedavi edildiği başarılı bir olgu sunulmuştur.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88892869","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 : 2020-12-28DOI: 10.26650/jchild.2020.3.819575
Ayşe Büyükcam
Amac: Insan brusellozu, bircok hastaligi taklit eden sistemik bir hastaliktir ve cocuklarda da teshis edilmesi cok zor olabilmektedir. Cocukluk cagi brusellozu, ciddi klinik tablolarla karsimiza gelebilir ve komplikasyonlara neden olabilir. Bu calismada, cocukluk cagi bruselloz hastalarinin ozellikleri ile hastaneye yatista laboratuvar belirteclerin tanisal rolunun arastirilmasi amaclandi. Gerec ve Yontemler: Geriye donuk olarak 1 Ocak 2018 ile 31 Aralik 2019 tarihleri arasinda bruselloz tanisi alan 0-18 yas 60 cocuk hasta degerlendirildi. Ayaktan ve hastaneye yatis verilerek izlenen bruselloz hastalarinin demografik ozellikleri ve klinikleri ile mikrobiyolojik ve diger laboratuvar bulgulari incelendi. Bulgular: Hastalarin yas ortalamasi, 9.3±4.3 yildi ve %41,7’si kiz, %58,3’u erkek idi. Hastalarin %83,3’unde eklem tutulumu mevcuttu. Hastalarin %33,3’u yatirilarak izlendi. Kan serum eozinofil sayilari yatan hastalarda ortanca degeri 60/µL (10-90/µL) iken ayaktan hastalarda 110/µL (55-205/ µL) degerleri arasinda idi (p=0,022). Kan eozinofil sayisi kesme seviyesi ≤90/µL icin; (CI %95, 54,4-93,9) duyarlilik %78,95 (Cl %95, 54,4-93,9) ve ozgulluk %60,00, (Cl %95,43,3-75,1) olarak bulundu. Sonuc: Cocukluk cagi brusellozu ulkemiz icin onemli bir halk sagligi sorunu olmaya devam etmektedir. Kan eozinofil duzeyleri, cocukluk cagi brusellozunda hastalik derecesini gostermede ve yatisa karar vermede bir role sahip olabilir ama bu iliskinin daha iyi anlasilmasi, ozgulluk ve duyarliliginin degerlendirmesi icin daha fazla sayida hasta ile yeni calismalara ihtiyac vardir.
{"title":"Çocukluk Çağı Bruselloz Özellikleri ve Hastaneye Yatışta Laboratuvar Belirteçlerinin Tanısal Rolü","authors":"Ayşe Büyükcam","doi":"10.26650/jchild.2020.3.819575","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.819575","url":null,"abstract":"Amac: Insan brusellozu, bircok hastaligi taklit eden sistemik bir hastaliktir ve cocuklarda da teshis edilmesi cok zor olabilmektedir. Cocukluk cagi brusellozu, ciddi klinik tablolarla karsimiza gelebilir ve komplikasyonlara neden olabilir. Bu calismada, cocukluk cagi bruselloz hastalarinin ozellikleri ile hastaneye yatista laboratuvar belirteclerin tanisal rolunun arastirilmasi amaclandi. Gerec ve Yontemler: Geriye donuk olarak 1 Ocak 2018 ile 31 Aralik 2019 tarihleri arasinda bruselloz tanisi alan 0-18 yas 60 cocuk hasta degerlendirildi. Ayaktan ve hastaneye yatis verilerek izlenen bruselloz hastalarinin demografik ozellikleri ve klinikleri ile mikrobiyolojik ve diger laboratuvar bulgulari incelendi. Bulgular: Hastalarin yas ortalamasi, 9.3±4.3 yildi ve %41,7’si kiz, %58,3’u erkek idi. Hastalarin %83,3’unde eklem tutulumu mevcuttu. Hastalarin %33,3’u yatirilarak izlendi. Kan serum eozinofil sayilari yatan hastalarda ortanca degeri 60/µL (10-90/µL) iken ayaktan hastalarda 110/µL (55-205/ µL) degerleri arasinda idi (p=0,022). Kan eozinofil sayisi kesme seviyesi ≤90/µL icin; (CI %95, 54,4-93,9) duyarlilik %78,95 (Cl %95, 54,4-93,9) ve ozgulluk %60,00, (Cl %95,43,3-75,1) olarak bulundu. Sonuc: Cocukluk cagi brusellozu ulkemiz icin onemli bir halk sagligi sorunu olmaya devam etmektedir. Kan eozinofil duzeyleri, cocukluk cagi brusellozunda hastalik derecesini gostermede ve yatisa karar vermede bir role sahip olabilir ama bu iliskinin daha iyi anlasilmasi, ozgulluk ve duyarliliginin degerlendirmesi icin daha fazla sayida hasta ile yeni calismalara ihtiyac vardir.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81688064","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 : 2020-12-28DOI: 10.26650/jchild.2020.3.780358
Demet Kivanç, Fatma Oğuz
Graft versus host hastaligi (GvHH) genellikle hematopoetik kok hucre nakli (HKHN) sonrasi gelisen ve nakil isleminin basarisini etkileyen onemli bir komplikasyondur. GvHH’nin iyi yonetilmesi, onlenmesi ve tedavi stratejilerinin gelistirilebilmesi icin patogenezi, risk faktorleri, prognozu ve biyobelirteclerinin tespit edilmesi onemlidir. Bu derlemede GvHH biyolojisinde etkili olan faktorlerden klasik ve klasik olmayan insan lokosit antijenleri (HLA) genleri, minor HLA antijenleri, sitokinler, kemokinler ve kostimulator molekuller ile ilgili literaturde yer alan guncel calismalar sunulmustur.
{"title":"GvHH Patogenezi ve Biyolojisi","authors":"Demet Kivanç, Fatma Oğuz","doi":"10.26650/jchild.2020.3.780358","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.780358","url":null,"abstract":"Graft versus host hastaligi (GvHH) genellikle hematopoetik kok hucre nakli (HKHN) sonrasi gelisen ve nakil isleminin basarisini etkileyen onemli bir komplikasyondur. GvHH’nin iyi yonetilmesi, onlenmesi ve tedavi stratejilerinin gelistirilebilmesi icin patogenezi, risk faktorleri, prognozu ve biyobelirteclerinin tespit edilmesi onemlidir. Bu derlemede GvHH biyolojisinde etkili olan faktorlerden klasik ve klasik olmayan insan lokosit antijenleri (HLA) genleri, minor HLA antijenleri, sitokinler, kemokinler ve kostimulator molekuller ile ilgili literaturde yer alan guncel calismalar sunulmustur.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77451798","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 : 2020-12-28DOI: 10.26650/jchild.2020.3.778936
Didem Yayla Karakurt, Esra Yücel, Deniz Özçeker, F. Beşer
Amac: Atopik dermatit tanili hastalarda banyo aliskanliklarinin ve nemlendirici kullaniminin hastaligin siddetine etkisinin saptanmasi ve ailelerin bu konudaki tutumlarinin belirlenmesi amaclandi. Gerec ve Yontem: Tanimlayici kesitsel tipteki calismamizda Okmeydani EAH Cocuk Alerji Poliklinigine basvuran atopik dermatit tanili hastalarin annelerine banyo sikligi, yikanma sekli, banyo suresi, banyoda kullanilan urunler ve nemlendirici kullanimi ile ilgili sorulari iceren anket uygulanarak veriler toplandi. Atopik dermatitin agirligini belirlemek icin Atopik Dermatit skorlamasi SCORAD (SCORing Atopic Dermatitis) skoru kullanildi. Hastalara ait serum total immunglobulin (Ig) E, eozinofil yuzdesi ve deri delme testi sonuclari hasta dosyasindan elde edildi. Bulgular: Calismaya 6 ay- 15 yas arasi 49’u erkek ve 51’i kiz hastanin annesi katilmistir. SCORAD skoruna gore hastalar gruplandirildiginda 48 hastanin hafif, 49 hastanin orta ve 3 hastanin ciddi atopik dermatiti (AD) oldugu goruldu. Atopik dermatit agirligi SCORAD’a gore gruplanan hastalarda banyo ile yikanma orani dus almaya oranla yuksek saptandi (p=0,001). Kisin her gun yikanma orani SCORAD skor sonucu agir dermatit ile uyumlu olanlarda; hafif ve orta olanlara (%22,45) gore daha yuksek saptandi (p=0,034). Nemlendirici kullanimi, sikligi ve kullanilan urunler ile AD agirligi arasinda anlamli iliski bulunmadi. Sonuc: Banyo seklinde yikanmanin dus almaya gore daha etkili olabilecegi tespit edilmistir. Atopik dermatit tedavisinde nemlendirici kullanimi ve ilac tedavisine ek olarak yikanma sekli ve kullanilan urunler onem tasiyabilir, bu durum ayrintili degerlendirilmelidir.
{"title":"Atopik Dermatit Tanılı Çocuklarda Banyo Alışkanlıkları ve Egzama Şiddetine Etkisi","authors":"Didem Yayla Karakurt, Esra Yücel, Deniz Özçeker, F. Beşer","doi":"10.26650/jchild.2020.3.778936","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.778936","url":null,"abstract":"Amac: Atopik dermatit tanili hastalarda banyo aliskanliklarinin ve nemlendirici kullaniminin hastaligin siddetine etkisinin saptanmasi ve ailelerin bu konudaki tutumlarinin belirlenmesi amaclandi. Gerec ve Yontem: Tanimlayici kesitsel tipteki calismamizda Okmeydani EAH Cocuk Alerji Poliklinigine basvuran atopik dermatit tanili hastalarin annelerine banyo sikligi, yikanma sekli, banyo suresi, banyoda kullanilan urunler ve nemlendirici kullanimi ile ilgili sorulari iceren anket uygulanarak veriler toplandi. Atopik dermatitin agirligini belirlemek icin Atopik Dermatit skorlamasi SCORAD (SCORing Atopic Dermatitis) skoru kullanildi. Hastalara ait serum total immunglobulin (Ig) E, eozinofil yuzdesi ve deri delme testi sonuclari hasta dosyasindan elde edildi. Bulgular: Calismaya 6 ay- 15 yas arasi 49’u erkek ve 51’i kiz hastanin annesi katilmistir. SCORAD skoruna gore hastalar gruplandirildiginda 48 hastanin hafif, 49 hastanin orta ve 3 hastanin ciddi atopik dermatiti (AD) oldugu goruldu. Atopik dermatit agirligi SCORAD’a gore gruplanan hastalarda banyo ile yikanma orani dus almaya oranla yuksek saptandi (p=0,001). Kisin her gun yikanma orani SCORAD skor sonucu agir dermatit ile uyumlu olanlarda; hafif ve orta olanlara (%22,45) gore daha yuksek saptandi (p=0,034). Nemlendirici kullanimi, sikligi ve kullanilan urunler ile AD agirligi arasinda anlamli iliski bulunmadi. Sonuc: Banyo seklinde yikanmanin dus almaya gore daha etkili olabilecegi tespit edilmistir. Atopik dermatit tedavisinde nemlendirici kullanimi ve ilac tedavisine ek olarak yikanma sekli ve kullanilan urunler onem tasiyabilir, bu durum ayrintili degerlendirilmelidir.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88725194","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 : 2020-12-28DOI: 10.26650/jchild.2020.3.822677
İ. Dönmez, Cengiz Haluk Bodur
A balance exists among the muscles in the head, neck, and oral region, which can be disrupted due to abnormal oral habits that may cause anomalies in the jaw skeletal system and occlusions, especially in children with continuing growth development. Cessation of poor oral habits before the age of 4 years can reduce the risk of developing malocclusions. Appropriate management of poor oral habits, which can otherwise cause malocclusions, is an important task for pediatric dentists. Methods such as behavioral orientation of the child, educating on the consequences of poor oral habits, and rewarding are often useful in helping the child quit such poor habits. However, occasionally, the child may resist on giving up these habits. In such cases, intraoral and extraoral appliances can be used. Therefore, it is important to raise awareness against malocclusions that may occur due to poor oral habits and their treatment approaches to parents, society, pediatricians, and pediatric dentists.
{"title":"Çocuklarda Kötü Ağız Alışkanlıkları ve Tedavi Yöntemleri","authors":"İ. Dönmez, Cengiz Haluk Bodur","doi":"10.26650/jchild.2020.3.822677","DOIUrl":"https://doi.org/10.26650/jchild.2020.3.822677","url":null,"abstract":"A balance exists among the muscles in the head, neck, and oral region, which can be disrupted due to abnormal oral habits that may cause anomalies in the jaw skeletal system and occlusions, especially in children with continuing growth development. Cessation of poor oral habits before the age of 4 years can reduce the risk of developing malocclusions. Appropriate management of poor oral habits, which can otherwise cause malocclusions, is an important task for pediatric dentists. Methods such as behavioral orientation of the child, educating on the consequences of poor oral habits, and rewarding are often useful in helping the child quit such poor habits. However, occasionally, the child may resist on giving up these habits. In such cases, intraoral and extraoral appliances can be used. Therefore, it is important to raise awareness against malocclusions that may occur due to poor oral habits and their treatment approaches to parents, society, pediatricians, and pediatric dentists.","PeriodicalId":86257,"journal":{"name":"The Journal of child psychiatry","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83945254","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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