Makale Arama

Amaç: Çocukluk döneminde Epstein-Barr virüsüne (EBV) nedenli enfeksiyöz mononükleoz olguları yüksek sıklıkta görülmektedir. Akut EBV enfeksiyonu belirti ve bulguları farklı klinik tablolarla kendini gösterebilmektedir. Çalışmamızda çocuklar arasında yaş ve yüksek riskli yaş gruplarına göre akut EBV enfeksiyonlarının klinik sunumunun incelenmesi amaçlandı.

Aim: In childhood, infectious mononucleosis cases caused by Epstein-Barr virus (EBV) are seen with high frequency. The signs and symptoms of acute EBV infection can manifest with different clinical pictures. Care should be taken in differential diagnosis for correct treatment. In our study, it was aimed to examine the clinical presentation of acute EBV infections by age and high-risk age groups among children.

Patients and Methods: A total of 337 pediatric patients with infectious mononucleosis who applied to our tertiary hospital in 2013-2020 were included in the study. EBV VCA IgM and IgG antibodies were studied by ELISA method (quantitative microplate ELISA, Euroimmun®, Germany) in accordance with company recommendations. Patient information and results were evaluated retrospectively.

Results: The mean age of the patients was 5.1 ± 3.4 years. 22.8% of the patients were in the group of 0-2, 43.0% of them were 3-5, 29.7% of them were 6-12, and 4.5% of them were 12 years old and above. The most common signs or symptoms in children diagnosed with acute EBV infection were lymphadenopathy (59.6%), lymphocytosis (45.1%), fever (40.9%), swelling in the throat (39.2%) and pharyngitis (30.0%). Fever complaints were significantly higher between the ages of 3-5 compared to other age groups. The seasonal distribution of the cases was similar. It was determined that the cases increased over the years and the most cases were seen in 2019 (23.4%). It was observed that the time between the start of complaints and the application to the hospital increased directly proportional to age groups.

Conclusion: In our study, it was concluded that there was no difference in acute EBV infection in childhood age groups in terms of signs and symptoms, and the number of cases increased slightly over the years, especially in children with lymphadenopathy, splenomegaly and hepatomegaly.

VSD is the most common cardiac malformation among congenital cardiac diseases and ocur in 3-6 in 1000 live births. The pattern of this defect may vary from a minor hole in the muscular septum, with a tendency to spontaneous closure, to complicated lesions requiring heart surgery. The aim of this study was to evaluate retrospectively long-term follow-up results and prognosis of pediatric patients with isolated VSD. The study was conducted in Selçuk University Medicine Faculty Pediatric Cardiology Department between July 2010 and February 2013. The echocardiography results of the patients with isolated VSD have been examined retrospectively. Among the included patients, % 71.52 of cases were perimembranous (n=103), % 40.6 of cases were muscular (n=80) and % 9.72 of cases were multipl VSD (n=14). Spontaneous closure rate was % 52.4 (n=54). % 22.3 of the cases required surgical closure because of heart failure. % 43.4 of the cases that requıred surgical closure were perimembranous VSD defects. VSD is the most common malformation of congenital cardiac diseases and can lead to heart failure by left to right shunt. And also the incidence of endocarditis in these patients has increased so the follow-up of the patients is significant.

Gastrointestinal procedures are the most frequent ones in outpatient anesthesia applications which increase day by day. However pediatric cases are rare. Out patient anesthesia applications, especially in pediatrik patients, are more difficult and so it is important to use guidelines in this manner. In this article our anesthetic experience in a endoscopic retrograde cholangiopancreatography applied on a pediatric patient is reported with literature review.

The aim of this study was to research the relationship between the difference in carotid intima media thickness and paraoxonase (PON1) in beta-thalassaemia major (BTM) children. We recruited fifty BTM patients (7.2±5.3 years, 34 boys and 16 girls) and 35 controls (7.9± 2.1 years, 23 boys and 12 girls) consecutively. In all subjects, serum PON1 activity and CIMT were measured. Mean CIMT was significantly increased in BTM patients relative to controls (P

Intake of high doses of calcium channel blocker can cause serious clinical consequences and death. A child patient at 13 years old was admitted to the intensive care unit because of significant hypotension due to high-dose amlodipine and valsartan+hydrochlorothiazide intake aiming commit suicide. The patient successfully treated with fluid, calcium gluconate, dopamine, dobutamine in addition to insulin and glucose was discharged from intensive care unit after eight days healthy by preventing development of further complications.

In 0-72 months aging children with early childhood caries, general anesthesia is often preferred due to the following reasons; the non-cooperation based on age, anxiety development during the dental procedures and long treatment sessions. It is known that early childhood caries have a significant impact on the quality of life of child patients’ and their families’. In the assessment of quality of life scores, different questionnaires were developed for children and their parents. Today, Parental Perception Questionnaire and Family Impact Scale, which are composed of two parts including Early Childhood Oral Health Impact Scale, is used for children under 6 years old age. This study included 158 patients who received comprehensive oral rehabilitation under general anesthesia in Necmettin Erbakan University, Department of Pediatric Dentistry and their parents. Demographic information and dmft values of the patients were recorded before the procedure. Parents were asked to complete the relevant questionnaire at the beginning of the procedure and at the 2nd and 4th weeks following the procedure. The data were statistically analyzed by the SPSS program. It was considered that if the effect size was greater than 0.7, a major change occurring in the data exchange. A statistically significant decrease in all values was observed after the treatments performed under the general anesthesia. The greatest reduction was found in the oral symptoms and functional status of the child. In conclusion, dental procedures performed under general anesthesia in children with early childhood caries appear to have a positive impact on the quality of life of patients and their families.

To determine the seropositivity ratios of hepatitis-B and hepatitis-C in pregnant women living in Kocaeli region. Three thousand seven hundred and fifty-six pregnant women who applied to Izmit Women and Child Health Hospital for delivery (vaginal delivery, cesarean) were included in this retrospective study. HBsAg, AntiHBs, Anti-HCV and Anti-HIV were detected by macro ELISA system in all pregnant women. Data were analysed with the SPSS statistical programme. Seropositivity of HBs-Ag, Anti-HBs and Anti-HCV were detected 2.2%, 3.7% and 0.3% respectively in pregnant. There were no pregnant women who have seropositivity with Anti-HIV. The results detected for seropositivity of hepatitis-B and hepatitis-C in Kocaeli region are similar to those found in other regions of Turkey.

It is not possible to determine dysrhythmias at any time, because those may occur briefly and unpredictably throughout the day. Transtelephonic electrocardiography (TTE) allows arrival to the hospital by the phone line dysrhythmia at the time. The aim of this study was to evaluate the value of TTE in the diagnosis and treatment of dysrhythmias, especially seen intermittently, in pediatric patients. We retrospectively evaluated records of 121 children, followed-up in Pediatric Cardiology Unit between May 2003 and May 2006. The patients were age of between 4 months to 18 years (median age 12 ± 4.4 years). The most common presenting symptoms were palpitation (42.1%), chest pain (15.7%), palpitation together with chest pain (6.6%), syncope (5%), easy fatigability (5%) and also the research of drug efficiency (3.3%). The dysrhythmia findings were determined on TTE in 21 of 110 cases whose standard electrocardiographies were normal. On TTE, supraventricular tachycardia was observed in three of 25 patients with normal HM. The dysrhythmia was detected in 24% of TTE records (supraventricular extrasystoles, ventricular extrasystoles, sinusal tachycardia, supraventricular tachycardia, sinus bradycardia, sinus tachycardia, sinus pause, Mobitz type I atrioventricular block were detected in 11, 7, 4, 3, 2, 1 and 1 cases, respectively). Four patients were using drugs (verapamil in 3 and propranolol in 1) before TTE recordings. According to the TTE records, medical treatments were started in 10 patients with previously untreated (verapamil in 5, propranolol in 3, digoxin in 1 and also amiodarone in 1). Eventually, we suggest that HM is a usefull, reliable and non-invasive diagnostic method for the detection of dysrhythmias in patients with dysrhythmia suggestive symptoms and normal ECG. Additionally, TTE should be used in follow-up and treatment of the patients with some dysrhythmias, even undetectable with HM.

Chest pain is a common complaint in children. It doesn’t usually indicate a cardiac problem but it is considered as heartache by the patients and their families. In this article, the patients with chest pain in pediatric cardiology clinic for the last 18 months have been evaluated and the etiology of chest pain has been discussed. The study includes 441 patients with chest pain, who were admitted to the Department of pediatrics, Division of pediatric cardiology, Faculty of Medicine, Selçuk University between May 2011 and November 2012. The data of the patients has been reviewed retrospectively. Medical history and family history of the patients, cardiac physical examination, electrocardiography, echocardiography, 24-hour rhythm holter monitoring, exercise testing and laboratory tests have been evaluated. In our study the mean age of the patients was 11 (5-18 year-old). 217 (49.2%) of the patients were male and 224 (50.8%) of the patients were female. Medical history, physical examination, electrocardiography and echocardiography of all the patients have been evaluated. Cardiac pathology has been recognized in 10 (2.3%) of the patients. The reasons that cause chest pain are idiopathic in 378 (85.7%) patients, psychological in 22 (5%) patients, lung diseases in 20 (4.5%) patients, gastrointestinal disorders in 6 (1.4%) patients, musculoskeletal system diseases in 3 (0.7%) patients, Familial Mediterranean Fever in 1 (0.2%) patient and pectus excavatum in 1 (0.2%) patient. According to this study, the etiology of chest pain in children is extra cardiac factors in majority. Differential diagnosis should be made carefully due to possibility of life threatening consequences of cardiac disorders. If there is no cardiac pathology as a result of medical history, physical examination and laboratory tests the patient and the family should be informed about this.

Ocular findings in children with neurofibromatosis type 1 (NF 1) and tuberous sclerosis (TS) are presented. The study was conducted prospectively and comprised 31children who were referred from pediatric neurology clinic to the ophthalmology clinic. Sixteen of 22 patients with NF1 (72.7%) were male and 6 (27.3%) were female and the mean age was 9.9 ± 4.2 (3-16 years). Two of 9 patients with TS (22.2%) were male and 7 (77.8%) were female, the mean age was 5.5 ± 3.6 (1.5-12 years). Twenty of children with NF1 had cooperation to the snellen chart, the mean visual acuity of the right and left eye were 0.93 ± 0.14 (0.4-1.0) and 0.94 ± 0.14 (0.4-1.0), whereas the mean visual acuity of 7 patients with TS was 0.84 ± 0.22 (0.4-1.0) at the right and 0.85 ± 0.19 (0.5-1.0) at the left eyes. Percentages of myopia, hyperopia and astigmatism in children with NF 1 were 40.9%, 4.5% and 18.1%, respectively. Percentages of myopia, hyperopia, astigmatism in children with TS were 11.1%, 22.2% and 11.1%, respectively. In a NF 1 patient with keratoconus, his visual acuity was 0.4. Also another patient with TS had diminished visual acuity of 0.4 at the right eye and 0.5 at the left eye because of hyperopic astigmatism. Iris Lisch nodules were detected in 14 (63.6%) of children with NF 1. Five cases (22.7%) had bilateral optic glioma, the mean age was 7.6 (3-15 years). All tumors were located at intraorbital and the patients were asymptomatic. Except optic glioma, it was found out that one patient (4.5%) had bilateral myelinated nerve fibers and the other one (4.5%) had bilateral optic atrophy due to previous neurosurgery. Sectorial iris hypopigmentation was determined in one (11.1%) of nine children with TS. Detailed ophthalmic examination has a great importance in patients with TS and NF 1 because of ocular findings which are commonly seen. Patients should be evaluated by ophthalmologists in terms of refractive error and optic glioma.

Aim of the recent study is to evaluate the relationship between endometrial sampling indications and histopathological results. Four hundred women who applied to Izmit Maternity and Child Health Hospital, and had endometrial sampling in 2011 were included in this retrospective study. Data was retrieved from patient’s files and pathology archives. Patients were grouped as menometrorrhagia, postmenopausal bleeding, pre-hysterectomy for myoma uteri and cervical polyp. Data was analyzed with a statistical processing program (SPSS). The mean age was 46.4±8.3 years. Indications of endometrial sampling were menometrorrhagia (62.3%), postmenopausal bleeding (22 %), pre-hysterectomy for myoma uteri (9.5%) and cervical polyp (6.2%), respectively. Of all the cases, 139 (55.8%) had menometrorrhagia with proliferative/secretory endometrium, 23 (9.2%) had endometrial hyperplasia and 1 (0.4%) had endometrial cancer for diagnosis. However, in postmenopausal bleeding group, 48 (54.5%) had atrophic endometrium, and 6 cases (6.8%) were diagnosed for endometrial adenocarcinoma. In prehsyterectomy for myoma uteri, 27 (71%) had proliferative/secretory endometrium, and no adenocancer was diagnosed. In cervical polyp group, 10 cases (40%) had endometrial polyps for diagnosis. General speaking, endometrial sampling should be applied in cases with postmenopausal bleeding and cervical polyps, but a more selective treat should be conducted in cases with menometrorrhagia and prehysterectomy for myoma uteri

Febrile seizures are seizures that occur in febrile children between the ages of 6and 60 months who do not have an intracranial infection, or history of afebrile seizures. In this study, the children’s demographic and clinical characteristics who had hospitalized for febrile seizures in Antalya Education and Research Hospital (AEAH) were reviewed. 56 children’s demographic and clinical characteristics who had hospitalized for febrile seizures between September 2011- January 2012 in AEAH were analysed retrospectively. Analyses were performed using SPSS 16.0 version. 23 patients (41.1%) were male, 33 (58.9%) were female , mean age was 26.8 months, mean duration of hospitalized days were 3.5 days. Fever source was upper respiratory tract infection in 44 (78.6%) patients, lower respiratory tract infection in 6 (10.7%), acute otitis media in 2 (3.6%), urinary tract infection in 1 (1.8%), acute gastroenteritis in 1 (1.8%), hand–foot-mouth disease in 1 (1.8%), roseola infantum in 1 (1.8%) patient. Lumbar punction was done in 2 (3.6%) patients, one of them had aseptic menengitis and other had normally cerebrospinal fluid findings. 34 (60.7%) patients had first attack, 12 (21.4%) had second, 5 (8.9%) had third and 5 (8.9%) had more than three attacks. 4 (7.1%) patient’s seizures who had first febrile attack occured more than once in a 24 hour period. 4 (7.1%) patients had complex febrile seizures, 1 (1.8%) patient had febrile status epilepticus. These results suggest that most febrile seizures are simple, good prognosis and mostly causes of fever is upper respiratory tract infection.

Angiomatoid Fibrous Histiocytoma (AFH) is a rare soft tissue tumour of indeterminate differentiation usually occurring in children and young adults with low rate of metastasis and recurrence. AFH continues to be revised with various studies reporting recurrences but up till now, the diagnostic criterion remains unclear with pathologists relying mainly on Enzinger’s description and immunohistochemistry. Adding to the fact that it is a rare tumour, diagnosis usually is delayed. We present a case of a 10 year old male with AFH with atypical histology, immunoprofile and genetic testing. Opinions were sought from Heidelberg hospital Germany and Children Hospital of Philadelphia which had contrasting views regarding the diagnosis, which was finally confirmed by Brigham and Women’s hospital, Boston. We review literature and discuss the possible differential diagnosis.

Atrophic rhinitis is a rarely witnessed inflamatory and chronic infection characterized by the atrophy of nasal mucosa and conchas, nasal crusting with bad smell and the enlargement of the nasal space with paradoxical nasal congestion. Primary and secondary forms of atrophic rhinitis are well-established. While primary atrophic rhinitis occurs in a previously healthy nose, secondary form frequently occurs following extensive sinus surgery, nasal trauma and chronic granulomatos diseases. On the physical examination of the case during anterior rhinoscopy, common crut and purulent, yellowish-dark green discharge were determined in nasal cavity. Klebsiella ozaenae and Staphylococcus aureus in aerobic culture with automated bacteria identification and susceptibiltiy testing system (Phoenix 100) and Actinomyces naeslundii in anerobic culture were yielded. Klebsielle ozaenae was found to be resistant only to ampicillin and was susceptible all the other tested antibiotics, and expanded spectrum beta-lactamase (ESBL) was negative. Staphylocccus aureus was found to be resistant to cefazolin, clindamycin, erythromycin, fucidic acid, meropenem, oxacillin, penicillin G and ampicillin. Actinomyces naeslundii was found to be resistant to metronidazole; susceptible to moxifloxacin and meropenem, with E-test method and beta lactamase test was negative. Presenting atrophic rhinitis in a 10-year-old male patient with clinical, microbiological and pathological features, the subject were discussed in the light of related literature.