Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Which has an Influence on Mean Platelet Volume: Allergic Rhinitis or Asthma?(2022) Senol, Handan Duman; Ozdogru, Emine Ece; Sancakli, Ozlem; Dogru, Mahmut; Tuncel, TubaAim: Bronchial asthma and allergic rhinitis are mediated by similar allergic inflammatory mechanisms. Platelets play a role in allergic reactions which are inflammatory processes. The mean platelet volume (MPV) is a marker of platelet activation. This study aimed to investigate MPV value differences between children with allergic rhinitis during symptomatic or asymptomatic periods to determine whether MPV is a useful indicator of inflammation in allergic rhinitis. Materials and Methods: The records of those patients with allergic rhinitis were analyzed retrospectively. Patients over two years of age who had complete blood count results from both their asymptomatic and the symptomatic periods were included in this study. Clinical characteristics (age, age at diagnosis, symptoms, and comorbid allergic diseases) and laboratory data (thrombocyte count, MPV, white blood cell count, eosinophil count, and percentage, immunoglobulin E level, and skin prick test results) were recorded from the patient files and the hospital registry system. Results: MPV values during the symptomatic periods were statistically significantly higher than those from the asymptomatic period (p<0.001) in all patients. When the patients were grouped according to having asthma or not, MPV was found to be higher in the symptomatic period compared to the asymptomatic period in the group with asthma, but there was no difference between these two periods in the group without asthma (p=0.017, p=0.102 respectively). Additionally, MPV levels were significantly higher in the asthma group during both the symptomatic and the asymptomatic periods (p=0.04, p=0.013, respectively). Conclusion: This study suggests that MPV cannot be used as an inflammation indicator in the symptomatic period for patients with allergic rhinitis. Asthma influences MPV values. It is recommended to conduct more detailed and prospective studies to show MPV inflammation in AR.Item Clinicopathological Evaluation of Childhood Sacrococcygeal Germ Cell Tumors: A Single-Center Experience(2022) Hasbay, Bermal; Canpolat, Tuba; Aktekin, Elif; Ozkan, Hasan; Kekec, Senay Demir; 35781237Objective: We aimed to evaluate the cases of sacrococcygeal germ cell tumors diagnosed in our hospital between 2006 and June 2021. Materials and Methods::We evaluated 38 sacrococcygeal germ cell tumors cases in our series in terms of age, sex, clinical complaints, localization, macroscopy, tumor size, histopathological diagnosis, surgical, postoperative complications, treatment, recurrence, and prognosis. Results: The cases ranged from 1 day to 16 years of age; 14 cases were diagnosed with routine ultrasonographic examination during prenatal period while the rest of the cases most frequently presented with complaints of constipation. In terms of localization, 6 cases were type 1, 11 cases were type 2, 6 cases were type 3, and 15 cases were type 4. In the pathological evaluation, 25 cases were mature teratoma, 8 cases were immature teratoma, and 5 cases were pure yolk-sac tumor. In terms of complications, temporary colostomy was performed as a result of rupture during birth in 2 cases, disseminated intravascular coagulation at birth in 1 case, and colon injury in 2 cases. There was a recurrence in 2 of our cases. Thirty-seven of our cases were alive and 1 died. Alpha-fetoprotein level was high in 28 of our cases. Conclusion: In our series, type 4 cases were observed more frequently, contrary to the literature. We recommend to use a routine ultrasonography to patients who come to the clinic with complaints of constipation and inability to urinate and if a mass is detected, asking for alphafetoprotein for further follow-up. Sacrococcygeal germ cell tumors are ultimately a disease that can be successfully treated with multidisciplinary approach, accurate diagnosis in the antenatal and postnatal period, appropriate surgical intervention, and regular follow-up.Item Prevalence Of Inguinoscrotal Pathologies And Risk Factors In A Cohort Of 388 Children With Spina Bifida(2022) Ozel, S. Kerem; Kucuknane, Mustafa Alper; Ozgenel, Dicle Ozge; Ozer, Vuslat; Canaz, Huseyin; Alatas, Ibrahim; 35899567Background. There is limited information about the prevalence and risk factors of inguinal hernia and undescended testis in patients with spina bifida (SB). The aim of this study was to identify the properties and prevalence of inguinoscrotal diseases in these patients. Methods. A questionnaire was completed by parents of patients with the diagnosis of SB in our center. Together with demographic data, presence an of inguinal hernia, side, operation history, presence of ventriculoperitoneal (VP) shunt, type of SB aperta or occulta, recurrence and presence of undescended testis were questioned. Patients were grouped into 2 as SB aperta and occulta. The prevalence of these pathologies and their clinical properties were evaluated. Results. In this study, 388 patients were evaluated. Of these, 238 patients had SB aperta and 150, SB occulta. There was no significance in comparison of gender. The prevalence of inguinal hernia was 12.6% in general. A hernia was noted in 37 SB aperta patients (15.6%) whereas this was seen in 12 of the SB occulta patients (8%) (p=0.029). When there was a VP shunt, hernia prevalence was 21.5% and when there was no shunt, this ratio was 7.1% (p=0.0001). Prevalence of inguinal hernia was 21.8% in males and 3.2% in females (p=0.0001). When there was a VP shunt with SB aperta the prevalence was 21.9% and when a VP shunt was present with SB occulta, this number was found to be 13.3% (p=0.006). The prevalence of undescended testis was 17.7% and there was no difference between SB aperta and occulta patients. Conclusions. Inguinal hernia and undescended testis are more frequent in SB patients when compared to the normal population. VP shunts and male gender may be risk factors for inguinal hernia in these children. These findings may imply neurological factors in the etiology of inguinal hernia and undescended testis.Item Rituximab Treatment In Children With Difficult-To-Treat Nephrotic Syndrome(2022) Parmaksiz, GonulPurpose: Rituximab (RTX) has been offered as rescue therapy for patients with difficult-to-treat nephrotic syndrome (frequent relapsing, steroid-dependent and steroid resistant). We aimed to assess the efficacy and long-term outcomes of RTX treatment in children with difficult nephrotic syndrome and shared our experiences Materials and Methods: Medical records of children with difficult nephrotic syndrome who were treated with RTX were retrospectively evaluated. The relapse-free survival rate at 12 month and monitoring of B-cell depletion were assessed. Results: In the study included 20 children of which 8 had steroid-dependent (SDNS), 6 had frequent relapsing (FRNS), and 6 had steroid-resistant nephrotic syndrome (SRNS). The median number of relapses at 1 year before and after treatment in FRNS/SDNS patients receiving RTX treatment were compared. The median number of relapses decreased from 2 (1-4) to 0 (0-1) times/year. The mean duration of the follow-up period after RTX treatment was 23 (12-59) months, and 8 patients developed relapse. Repeated doses of RTX were administered to 5 patients who relapsed after RTX treatment. In these patients, CD19+B cells re-emerged during remission, while depletion of memory B-cells remained. Conclusion: The RTX treatment prolonged the remission time in FRNS/SDNS patients, but it was ineffective in SRNS patients. It was determined that the RTX doses can be repeated to maintain remission in these patients, and the best memory B-cell counts can help in timing the repeat doses.Item Evaluation of the Impact of Environmental Changes on Asthma Control in Children, Access to Health Care, and Treatment Adherence in Early COVID-19 Lockdown(2022) Sancakli, Ozlem; Tuncel, Tuba; Akarcan, Sanem Eren; Kanik, Ali; Ozyurt, Gonca; 35383020Objective: During the coronavirus disease 2019 pandemic, lockdown measures and difficulties in accessing healthcare have impacted asthma management in children. This study aimed to determine the evaluation of the impact of environmental changes on asthma control in children, access to health care, and treatment adherence in early coronavirus disease 2019 lockdown. Materials and Methods: The study included children with asthma aged 6-11 years. A survey form was administered to the patients who visited the pediatric allergy outpatient clinic between June 1 and 30, 2020. The survey acquired demographic information about the children and their families as well as information about their asthma symptoms, how they reached healthcare services, and adherence. The childhood asthma control test was administered. The P values < .05 were considered significant. Results: The study included a total of 123 children (female/male : 48/75) with a mean age of 8.4 +/- 1.9 years. According to the mothers' self-report, it was found that 78% of the patients were not able to follow-up routinely, 19.5% were non-adherence to treatment, and 16.2% were poorly controlled asthma. It was found that, based on childhood asthma control test scores, asthma control was better during the pandemic lockdown period (P = .001). Asthma symptoms were better in 41.5% of the patients compared to the previous months and in 53.7% compared to the same period last year. Conclusion: Our study found that the children's asthma was controlled although most of them did not have their follow-up visits, and poorly controlled asthma was higher in older children in early coronavirus disease 2019 lockdown.Item Low-Dose Antibiotic Prophylaxis Induces Rapid Modifications of the Gut Microbiota in Infants With Vesicoureteral Reflux(2021) Morello, William; D'Amico, Federica; Serafinelli, Jessica; Turroni, Silvia; Abati, Isabella; Fiori, Jessica; Baskin, Esra; Yalcinkaya, Fatos; Jankauskiene, Augustina; Pennesi, Marco; Zurowska, Aleksandra; Becherucci, Francesca; Drozdz, Dorota; Mekahli, Djalila; Krzemien, Grazyna; La Scola, Claudio; Taranta Janusz, Katarzyna; Mehls, Otto; Schaefer, Franz; Candela, Marco; Montini, Giovanni; 34222145Background and Objectives: Maturation of the gut microbiota (GM) in infants is critically affected by environmental factors, with potential long-lasting clinical consequences. Continuous low-dose antibiotic prophylaxis (CAP) is the standard of care for children with vesicoureteral reflux (VUR), in order to prevent recurrent urinary tract infections. We aimed to assess short-term GM modifications induced by CAP in infants. Methods: We analyzed the GM structure in 87 infants (aged 1-5 months) with high-grade VUR, previously exposed or naive to CAP. Microbial DNA was extracted from stool samples. GM profiling was achieved by 16S rRNA gene-based next-generation sequencing. Fecal levels of short- and branched-chain fatty acids were also assessed. Results: 36/87 patients had been taking daily CAP for a median time of 47 days, while 51/87 had not. In all patients, the GM was predominantly composed by Bifidobacteriaceae and Enterobacteriaceae. Subgroup comparative analysis revealed alterations in the GM composition of CAP-exposed infants at phylum, family and genus level. CAP-exposed GM was enriched in members of Enterobacteriaceae and Bacteroidetes, especially in the genera Bacteroides and Parabacteroides, and showed a trend toward increased Klebsiella, often associated with antibiotic resistance. In contrast, the GM of non-CAP children was mostly enriched in Bifidobacterium. No differences were found in fatty acid levels. Conclusions: In infants with VUR, even a short exposure to CAP definitely alters the GM composition, with increased relative abundance of opportunistic pathogens and decreased proportions of health-promoting taxa. Early low-dose antibiotic exposure might bear potential long-term clinical risks.Item The effects of maternal anxiety and attitudes on the adherence to inhaled corticosteroids in children with asthma(2021) Sancakli, Ozlem; Aslan, Asli Akin; 33938199Objective: Long-term inhaled corticosteroid (ICS) use in children with asthma causes serious concerns in parents, leading to treatment non-adherence. This study aimed to investigate the effect of maternal anxiety and attitudes on adherence to ICS therapy in children with asthma. Method: The patient group included the children with mild to moderate persistent asthma, aged 6-11 years. Healthy children in a similar age range were included as a control group. The patient group was divided into two categories (treatment adherent and non-adherent) according to the regularity of ICS use. All patients were assessed with Childhood-Asthma Control Test (C-ACT), and their mothers were assessed using Parent Attitude Research Instrument (PARI) and Beck's Anxiety Inventory (BAI). Results: A total of 156 children (age: 7.4 +/- 1.4 years, F/M: 71/85) with persistent asthma and 60 healthy children (age: 7.5 +/- 1.3 years, F/M:25/35) were included in the study. The rate of adherence in children with asthma was 52.6%. Mothers of non-adherent patients had significantly higher BAI scores than those of the adherent patients and controls (p < 0.001 and p < 0.001, respectively). The number of mothers who indicated that they did not have enough information about asthma and treatment was also higher in the non-adherent group. PARI subtest scores were not different between the adherent and non-adherent groups. Conclusions: In our study, it was found that mothers' anxiety levels and their knowledge about asthma and medications were associated with treatment adherence in children with asthma. Psychological and educational support to the families of children with asthma would improve their treatment adherence and efficacy. (C) 2021 Codon Publications. Published by Codon Publications.Item Effect of Passive Tobacco Smoking Exposure on the Periodontal Status of Turkish Children(2021) Alan, Raif; Gezgin, Onur; Korkut, Emre; Turkoglu, Sukriye; Celik, Esra; Haliloglu, SeyfullahObjective: This study aimed to assess the effect of passive tobacco smoking (PTS) through the comparison of the periodontal status and the C-reactive protein (CRP) and cotinine levels in the biologic fluids in children who are exposed and unexposed to PTS. Methods: A total of 148 participants, whom had smokers (PTS-exposed, n=82) and non-smokers (PTS-unexposed, n=66) in their families, respectively, were included in the study. Gingival index, plaque index, probing depth, and bleeding on probing were recorded. Moreover, saliva, urine, and gingival crevicular fluid samples were collected. CRP and cotinine levels in the biological fluids were determined by the enzyme-linked immunosorbent assay method. Results: Both groups exhibited similar values for periodontal parameters and salivary CRP levels were higher in PTS-exposed group but not significant. The mean urinary cotinine level was significantly higher in children exposed to PTS than in unexposed children. Conclusions: There was no evidence for causative role of PTS in periodontal disease in this study. Longitudinal studies including large populations should be conducted to provide stronger evidence for the causative role of PTS in periodontal disease. Also, further epidemiological studies on the social context of smoking should be performed to improve the quality of life and lifespan of the society.Item Evaluation of acute respiratory distress syndrome cases in a pediatric intensive care unit(2021) Turhan, Inci; Yildizdas, Dincer; Yontem, AhmetPurpose: The aim of this study was to evaluate the lung-protective mechanical ventilation strategy, early enteral nutrition, negative fluid balance, and adequacy of hospital resources in our pediatric intensive care unit. Materials and Methods: This study included 32 patients who developed acute respiratory distress syndrome (ARDS) during their monitoring in the pediatric intensive care unit. Results: According to their oxygenation status, 14 patients (43.8%) had mild ARDS, nine patients (28.1%) had moderate ARDS, and nine patients (28.1%) had severe ARDS. High-frequency oscillatory ventilation was applied to three patients (9.3%), and four patients (12.5%) received extracorporeal membrane oxygenation (ECMO) support. The most common complications were nosocomial infection (31.3%) and pneumothorax (12.5%). The mortality rate was 6.3%. The survival rate was 75.0% in patients with ECMO support. The patients with a higher Pediatric Index of Mortality (PIM-2) score confronted more severe ARDS, and non-pulmonary ARDS also progressed in advanced stages. Conclusion: In patients with high PIM-2 and PELOD scores, attention must be given to the development of severe ARDS. The lung-protective mechanical ventilation support, early enteral nutrition, negative fluid balance practices, and the adequacy of hospital resources led to a successful survival rate in our study. However, multicenter randomized controlled trials are needed on this subject.Item The role of body temperature on respiratory rate in children with acute respiratory infections(2021) Ozdemir, Beril; Yalcin, Siddika Songal; 34795718Background: The World Health Organization (WHO) recommends the use of tachypnea as a proxy to the diagnosis of pneumonia. Objective: The purpose of this study was to examine the relationship between body temperature alterations and respiratory rate (RR) difference (RRD) in children with acute respiratory infections(ARI). Methods:This cross-sectional study included 297 children with age 2-60 months who presented with cough and fever at the pediatric emergency and outpatient clinics in the Department of Pediatrics, Baskent University Hospital, from January 2016 through June 2018. Each parent completed a structured questionnaire to collect background data. Weight and height were taken. Body temperature, respiratory rate, presence of the chest indrawing, rales, wheezing and laryngeal stridor were also recorded. RRD was defined as the differences in RR at admission and after 3 days of treatment. Results: Both respiratory rate and RRD were moderately correlated with body temperature (r=0.71, p<0.001 and r=0.65, p<0.001; respectively). For every 1 degrees C increase in temperature, RRD increased by 5.7/minutes in overall, 7.2/minute in the patients under 12 months of age, 6.4/minute in the female. The relationship between body temperature and RRD wasn't statistically significant in patients with rhonchi, chest indrawing, and low oxygen saturation. Conclusion: Respiratory rate should be evaluated according to the degree of body temperature in children with ARI. How-ever, the interaction between body temperature and respiratory rate could not be observed in cases with rhonchi and severe pneumonia.