Turkish Journal of Pediatric Disease
ISSN / EISSN: 13074490 / 21483566
Published by: Turkish Journal of Pediatric Disease
Total articles ≅ 802
Latest articles in this journal
Published: 26 January 2023
Turkish Journal of Pediatric Disease pp 1-6; https://doi.org/10.12956/tchd.1216596
Objective: Cough is one of the leading causes of hospitalization in children worldwide. It should be considered important because it can be a symptom of various serious diseases and affects the quality of life of the child. A differential diagnosis should be performed on all children with a chronic cough. This study aimed to determine the etiologies in patients evaluated for chronic cough. Material and Methods: The study included patients admitted to the pediatric immunology and allergy outpatient clinic, with the complaint of chronic cough between the ages of 0–18 years. Clinical and demographic characteristics of patients were recorded. Results: This study included 323 patients between the ages of 0-18years. The median age of the patients was 7 (interquartile range: 5-9.7) years. One hundred and forty five (45%) of the patients were female. One hundred seventy-nine (55.4%) patients had a family history of atopic diseases such as asthma and/or allergic rhinitis. The presence of aeroallergen sensitivity was demonstrated in 127 patients. One hundred and forty-four (44.6%) patients were diagnosed with asthma, 75 (23.2%) patients with wheezing, 54 (16.7%) patients with post-infectious cough, 43 (13.3%) patients with postnasal drip syndrome, 4 (1.2%) patients with gastroesophageal reflux, 2 (0.6%) patients with foreign body aspiration, and 1 (0.3%) patient with psychogenic cough. Moreover, two patients with asthma, and one patient with wheezing had reflux symptoms in addition to the diagnosis of asthma and wheezing. One patient was found to have a partial IgA deficiency, and 18 patients had hypogammaglobulinemia. Immunoglobulin replacement therapy was initiated for a patient with hypogammaglobulinemia. Of the 219 patients diagnosed with asthma or wheezing, 144 had an atopic disease in the family (p<0.001). It was found that one hundred and eighty-five patients (57.3%) had domestic smoke exposure. Furthermore, smoke exposure was observed in 58 (77.3%) of 75 patients under the age of 6 years who were followed up with the diagnosis of wheezing (p= 0.010). Conclusion: In our study, asthma, which is one of the most common causes of chronic cough in the literature, was found to be the most common cause. For a correct approach when making a differential diagnosis in pediatric patients presenting with chronic cough, the patient’s history, physical examination, laboratory tests, and risk factors should be evaluated as a whole with systematic evaluation.
Published: 26 January 2023
Turkish Journal of Pediatric Disease pp 1-7; https://doi.org/10.12956/tchd.1211443
Objective: In this study, it was aimed to examine the clinical and sociodemographic characteristics of patients hospitalized in Ankara City Hospital Child and Adolescent Psychiatry Inpatient Unit during the pandemic period. Material and Methods: Medical records of children and adolescents who were hospitalized in Ankara City Hospital Child and Adolescent Psychiatry Inpatient Unit between March 2021 and March 2022 were retrospectively analyzed. Patients were evaluated in terms of sociodemographic characteristics, clinical diagnosis and treatment, duration of hospitalization, and Clinical Global Impression Scale (CGI) scores at admission and discharge. Results: In our study, the mean age of 132 cases (86 girls, 46 boys) was found 15.1±1.8 years. The main diagnoses of the subjects were 30.3% (n=40) major depressive disorder, 25% (n=33) psychotic disorder, 14.4% (n=19) eating disorders, and the remaining 30.3% (n=40) were other disorders. Comorbidity was found in 63.6% (n=84) of the cases. The presence of eating disorders, comorbidity and antidepressant use were found significantly higher in females. There was a significant differences in major depressive disorder (MDD), bipolar disorder (BD), psychotic disorder, eating disorder, conduct disorder, and post-traumatic stress disorder (PTSD) between admission and discharge CGI-Severity (CGI-S) scores. In addition, there was a significant difference between admission and discharge CGI side effects scores only for BD. Conclusion: In our study, major depressive disorder, psychotic disorder, and eating disorder were the most common diagnoses of cases hospitalized in inpatient unit. There was a comorbidity accompanying two out of every three cases. There are few child and adolescent psychiatry services in our country, and studies on this subject are scarce. It is thought that our study will contribute to the literature on child and adolescent psychiatry inpatient units.
Published: 24 January 2023
Turkish Journal of Pediatric Disease pp 1-7; https://doi.org/10.12956/tchd.1199280
Objective: The aim of this current study was to determine mothers’ infant sleep position practices and their awareness of a safe sleeping environment. Material and Methods: This descriptive survey was conducted with 418 mothers who had infants aged 0-6 months and who agreed to participate in pediatric outpatient polyclinics of two hospitals. Data were collected between January-December 2020 via-structured questionnaires by face-to-face interview. Results: Of the 418 mothers; 28% placed their babies in the supine sleeping position, 59.6% used a pillow when they put their babies in bed and 76.8% used a soft mattress. 42.3% of mothers covered their babies’ faces during sleep; primary school graduate mothers were more intended on covering their babies’ faces than high school and university graduates (p<0.001). 4.1% of mothers smoked during pregnancy, 9.8% during the lactation period and 15.3% were exposed to household smoke. All of the mothers shared a room with their babies without sharing a bed. There was also a positive correlation between the number of prenatal visits of mothers and their preference to put their babies to sleep in the supine position (p=0.010). Conclusion: Most of the mothers placed their babies in a side sleeping position. Mothers’ avoiding sharing beds and smoking cigarettes and prone positioning their children at a very low frequency were pleasing measures. Mothers who had more prenatal visits were found to place their babies more in the supine sleep position. Increasing the awareness of healthcare providers and other secondary caregivers about a safe sleeping environment and baby sleep position during pre and postnatal visits would make right practices become widespread.
Published: 18 January 2023
Turkish Journal of Pediatric Disease pp 1-6; https://doi.org/10.12956/tchd.1205598
Objective: A cough that lasts longer than four weeks in children is called chronic cough. The aim of this study is to determine the underlying causes of chronic cough. Material and Methods: Patients aged 0-18 years who were referred to Şanlıurfa Training and Research Hospital pediatric pulmonology outpatient clinic between 27 December 2021 and 30 June 2022 due to chronic cough were enrolled. Patients with known cystic fibrosis, primary ciliary dyskinesia, interstitial lung disease, asthma, bronchopulmonary dysplasia were excluded from the study. The “CHEST Guideline and Expert Panel Report” guideline was used in the approach to chronic cough. Results: 153 patients were included in this study. The most common causes of chronic cough were asthma (30.7%), protracted bacterial bronchitis (20.3%), and upper respiratory tract cough syndrome (11.1%). Wet cough was present in 60.8% of the patients with chronic cough and the most common diagnosis in patients with wet cough were protracted bacterial bronchitis (33.3%), pneumonia and other lung infections (17.2%) and bronchiectasis (12.9%). The most common diagnoses were asthma (68.3%), upper airway cough syndrome (6.7%), and natural recovery (6.7%) in patients with dry cough. Failure to thrive was more common in patients with wet cough than patients with dry cough (p<0.030) and fever, weight loss and desaturation were only present in patients with wet cough. Conclusion: The most common reasons are asthma, protracted bacterial bronchitis and upper airway cough syndrome. The differential diagnosis should be made by pediatricians based on specific cough pointers, careful physical examination and tests performed in line with the recommendations of the guidelines.
Published: 17 January 2023
Turkish Journal of Pediatric Disease pp 1-7; https://doi.org/10.12956/tchd.1204367
Objective: This study aimed to determine the clinical efficacy of erythrocyte transfusion (ET) in premature infants. Material and Methods: Very low birth weight (VLBW) infants with gestational age (GA) < 32 weeks and/or birth weight (BW) <1500 g and hospitalized in neonatal intensive care unit (NICU) between 2012-2018 were retrospectively evaluated. ET was performed according to Ohls 2007 and Turkish Neonatalogy Society Blood Products Transfusion Guidelines. Results: 72 infants included in this study. Mean BW was 1325 g (680-2290 g), GA was 30 weeks (25-32), median postnatal age was 36.7±26.9 days (8-129), number of ET during hospitalization was 2±1.2 (1-6). There were no significant changes in mean heart rates (p=0.183) and median respiratory rates before and after ET (p=0.123). Weight gain (16 g/day-11 g/day) was statistically similar before and after ET (p=0.861). A significant decrease in apnea, non-invasive ventilation (NIV) and caffeine therapy requirements after ET was determined (p<0.001, p=0.016 and p=0.016). Serum lactate (2.9-1.5) levels were decreased by ET (p=0.017). Conclusion: Premature infants should closely follow-up for anemia and related symptoms during NICU stay. ET may help to decrease frequency of apnea of prematurity, requirements of caffeine therapy and NIV. ET improves tissue oxygenation in VLBW infants with anemia. Decision of ET should be made according to severity of symptoms, and should be performed according to international, national or local transfusion guidelines.
Published: 12 January 2023
Turkish Journal of Pediatric Disease pp 1-6; https://doi.org/10.12956/tchd.1196564
Objective: Iron is an element, which is found in the structure of antioxidant enzymes and has an important role in the inactivation of reactive oxygen species. Disruption of oxidant-antioxidant balance may be playing a role in the pathogenesis of iron deficiency anemia (IDA). Dynamic thiol-disulfide homeostasis (DTDH) and serum ischemia-modified albumin (IMA) levels are important indicators of pro-oxidant/antioxidant status. In this study, we aimed to evaluate DTDH parameters and serum IMA levels in children with newly diagnosed IDA, who did not receive iron therapy. Material and Methods: Fifty patients diagnosed with IDA and 33 healthy age- and sex-matched control patients were included in the study. DTDH parameters and IMA levels of the patients and control groups were measured. The same parameters were also compared in patients with Hb<7 g/dl (profound IDA) (n:14/50, 28%) and Hb≥7 g/dl (mild-moderate IDA) (n: 36/50, 72%) in the IDA group. The relationship between DTDH parameters in these groups were investigated. Results: Native thiol, total thiol, native thiol/total thiol levels, constituting antioxidant capacity indicators, were found to be significantly lower in IDA patients; while oxidant disulfide, disulfide/native thiol, disulfide/total thiol, and IMA levels were found to be statistically higher compared to those in the control group (p<0.050). When DTDH parameters and IMA levels were examined; there was a positive correlation between antioxidant parameters and a negative correlation between oxidative parameters with hemoglobin and ferritin levels (p7 g/dl (p<0.050). Conclusion: In this study, increase in serum disulfide and IMA levels with the decrease in serum native thiol and total thiol levels indicated oxidative stress in IDA patients before treatment, compared to the control group. Evaluation of these indicators in children is important in predicting the toxicity due to IDA.
Published: 12 January 2023
Turkish Journal of Pediatric Disease pp 1-7; https://doi.org/10.12956/tchd.1213912
Objective: The aim of this study was to evaluate the clinical characteristics of children with cerebral palsy (CP) and to investigate possible risk factors and prognosis of epilepsy in children with cerebral palsy (CP) with a special emphasis on drug-resistant epilepsy (DRE). Materials and Methods: A total of 145 pediatric patients who were followed up with a diagnosis of CP between 2019 and 2022 were evaluated. Demographic features, prenatal/perinatal history, etiology and type of CP, degree of impairment in motor and cognitive functions, seizure type, neuroimaging, and electroencephalography (EEG) findings were obtained retrospectively from hospital records. The patients were divided into two groups: CP patients with epilepsy and patients without epilepsy. Study variables were compared between these two groups and also between DRE and controlled epilepsy groups. Results: There were 91 (63%) boys and 54 (37%) girls with a mean age of 11.1 ± 4.2 years (3-18 years). Epilepsy was present in 107 (73.7%) cases and 40.1% of them had refractory epilepsy. Epilepsy was most common in the tetraplegic form of CP (p=0.028). Term gestation, birth weight of ≥2500 g, and history of neonatal seizures were significantly higher in patients with epilepsy (p=0.03, 0.01, and 0.03, respectively). Children with DRE were more likely to have tetraplegic CP (50%) and severe intellectual disability (56%). Conclusion: Determination of potential risk factors is important in predicting the development of epilepsy in patients with CP, as it may provide closer follow-up of patients at high risk. Particular attention should be paid to the early identification and treatment of comorbid epilepsy in children with CP.
Published: 11 January 2023
Turkish Journal of Pediatric Disease pp 1-6; https://doi.org/10.12956/tchd.1206118
Amaç: İnfluenza aşısının astım kontrolü üzerindeki etkisi tartışmalıdır. Bu çalışmanın amacı astımlı çocuklarda influenza aşısının hastalık kontrolüne etkisini araştırmaktır. Gereç ve Yöntemler: Astım tanısı alan çocuklar prospektif olarak çalışmaya dahil edildi. Hastaların sosyo-demografik özellikleri, bir önceki yılda influenza aşısı olma durumu, bronkodilatatör kullanımı ve sistemik steroid tedavisi, hastaneye yatış sıklığı, aşılam durumunu ve hastalığın kontrol durumunu etkileyecek risk faktörleri araştırıldı. Bulgular: Çalışmaya ortanca yaşı 11 olan toplam 187 astımlı çocuk dahil edildi. Hastaların yaklaşık yarısında (%47,6) astım kontrol altında değildi. Son bir yılda %14,4'ü, %14,4'ü iki, %19,3'ü ≥3 atağı geçirirken, %51,9'u astım atağı geçirmedi. Bir önceki yılda hastaların %52,4'ü grip aşısı olmuştu. İnfluenza aşılaması, kontrollü ve kontrolsüz astımı olan hastalarda eşit oranda yaygındı (%54.1'e karşı %50.6) ve aşılamanın hastalık kontrolü üzerinde etkisi yoktu (p=0.662). Alerjik riniti ve atopisi olan hastalarda, alerjik riniti olmayan hastalara göre anlamlı olarak daha yüksek kontrolsüz astım durumu vardı (sırasıyla p=0.027 ve p=0.041). Kontrolsüz astımı olan çocuklar kontrol grubuna göre daha az profilaktik ilaç kullanmışlardı (p<0.001). Sonuç: İnfluenza aşısının astımlı çocuklarda hastalık kontrolüne etkisi yoktur. Alerjik rinit ve atopiye sahip olmak hastalığın kontrolünü azaltır.
Published: 11 January 2023
Turkish Journal of Pediatric Disease pp 1-7; https://doi.org/10.12956/tchd.1205213
Amaç: Çalışmamızda pediatrik sistemik lupus eritematozus (SLE) hastalarında, hastalık prezentasyon bulgularının, hastalığın 2. yılındaki düşük hastalık aktivitesi ve remisyona ulaşmadaki etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Merkezimizde takipli olan pediatrik SLE hastalarının elektronik tıbbi kayıtları ve hasta dosyalarından demografik, klinik ve laboratuvar verileri kaydedildi. Hastalığın 2. yılındaki aktivite ölçümü SLE Hastalığı Aktivite İndeksi-2000 (SLEDAI-2K) skoru baz alınarak hesaplandı. Prezentasyon bulguları ile düşük hastalık aktivitesi ve remisyon arasında ilişki olup olmadığı istatiksel yöntemlerle incelendi.Sonuçlar: Bu çalışmaya merkezimizde pediatrik SLE tanısı almış ve en az 2 yıl düzenli takibe gelmiş 29 hastayı dahil ettik. Tanıdan sonraki 2. yılda hastalarda SLE aktivite ölçümüne göre 14 hastada (%48.2) HDAS, 15 hastada (%51,7) LDAS-remisyon elde edilmişti. İki grup arasında başlangıçtaki prezentasyon bulguları açısından anlamlı istatiksel farklılık saptanmadı. 5. yılda 15 hastadan 6’sında (%40) LDAS-remisyon, 9’unda (%60) HDAS mevcuttu. 2. yılda HDAS’a sahip hastaların 5. yıl SLEDAI-2K skorları, 2. yılda LDAS-remisyona sahip hastaların 5. yıl SLEDAI-2K skorlarına göre anlamlı olarak yüksekti (p= 0.028). Ayrıca 2. yılda aktif olan 8 hastanın (%80) 5. yılda HDAS’ın devam ettiği gözlendi.Tartışma: Çalışmamızda pediatrik SLE prezentasyon bulgularının hastalığın 2. yılındaki düşük hastalık aktivitesi ve remisyon üzerine belirleyici etkilerinin olmadığını gösterildi. Ayrıca 2. yılda elde edilen düşük hastalık aktivitesi ve remisyon 5. yıldaki düşük hastalık aktivitesi ve remisyonun belirleyicisi olabilir.
Published: 28 December 2022
Turkish Journal of Pediatric Disease pp 1-5; https://doi.org/10.12956/tchd.1179829
Objective: A pandemic is an epidemic of an infectious disease that has spread across a large region of the world and affects many people. In this study, it was aimed to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on ambulance use by pediatric patients in Ankara Province, Turkey. Material and Methods: This retrospective study was conducted in the spring-summer of 2019 and 2020. The electronic medical records of pediatric patients who were transported to the hospital by ambulance were analyzed. Results: It was determined that 49.6% of the 23.201 patients included in the study were transported during the pandemic period. Male gender was higher in both the pandemic and pre-pandemic periods, there was no difference in terms of average age. The rate of forensic cases and refugee patients increased, while that of emergency patients decreased. Both the arrival at the scene time and intervention time were prolonged. Medical cause was the most common cause of emergency calls in both years, however, it increased significantly in 2020. The decrease in cases of traffic accidents, suicides, and other accidents was statistically significant. In the pandemic period, total rate of COVID-19 infection and suspicion was 29.7%. Most of the patients had been referred to a public hospital. Conclusion: It was found that most of the ambulances were used for transporting patients with minor illnesses that did not require immediate medical attention in pandemic period.