Sırt Ağrısı ile Başvuran Adölesan Bir Hastada Saptanan Pott Hastalığı

Giriş: Spinal kemik tüberkülozu olarak da bilinen Pott hastalığı, endemik ülkelerde erişkin yaş gruplarında sık bildirilse de çocuk yaş grubu için sık görülen bir durum değildir. Burada başvuru değerlendirmesi ile skrofuloderma ön tanısı alan ve izleminde Pott apsesi de saptanan adölesan bir olgu sunulmaktadır. Olgu: On dört yaşında kız hasta, 5 ay önce sağ meme altında başlayan akıntılı yara ve sırt ağrsı şikayetiyle dermatoloji kliniğine başvurmuş. Bilinen psöriazis tanılı hasta, uygulanan çeşitli tedavilere rağmen devam eden yakınmaları nedeniyle tarafımıza yönlendirilmiş. Sistem muayenelerinde patoloji olmayan hastada birkaç adet psöriyatik lezyon ile sağ ve sol aksiller bölgede sırasıyla 2x2 cm ve 1x1,5 cm lenfadenopati saptandı. Sağ meme altında 5x3 cm boyutlu inflame görünümde akıntılı endüre lezyon izlendi(Şekil 1). Babasında geçirilmiştüberküloz hastalığı olduğu öğrenildi. Laboratuvar tetkikleri mikrositer anemi ile uyumlu olan hastada akut faz reaktanları negatif sonuçlandı. Meme altındaki lezyondan alınan biyopsi örneği yoğun granülamatöz nekrotik enflamasyon olarak raporlandı. Skrofuloderma ön tanısı ile alınan örneğe ait kültür sonuçları beklenirken tüberküloza yönelik tetkikler planlandı. Bacillus Calmette-Guérin skarı izlenmeyen hastanın tüberkülin deri testi 17 mm sonuçlandı. Aile taramasında aktif tüberküloz hastalığı saptanmadı. Toraks tomografisinde patolojik lenf nodu veya parankim dokusu olmayan hastanın T10-11 vertebra korpusları sağ yarımı ve 11. kostovertebral bileşkeyi infiltre ederek T11 vertebra korpusunda fraktüre sebep olup spinal kanalı daraltan, 48x40 mm ölçülen kitle lezyonu izlendi(Şekil 2). Ayrıca sağ 5. kosta anteriorunda kostayı infiltre ederek cilde açılan 32x26 cm boyutlu lezyon da görüldü. Yara yerinden alınan örneğin kültür sonuçunda M. tuberculosis üremesi olduğu saptandı. Nöroşirurji ile de konsulte edilen hastanın spinal bölgedeki lezyonu Pott apsesi ile uyumlu bulundu. Kemik tüberkülozu tanısı alan hastaya dörtlü antitüberküloz tedavi başlandı. Sonuç: Nadir görüldüğü bu yaş grubunda tanıda gecikmenin de etkisiyle paraplejiye varabilecek yıkıcı sonuçlar meydana gelebilir. Sırt ağrısı gibi spesifik olmayan bir semptomla başvuran hastalarda ayırıcı tanıda mutlaka akla gelmelidir

Adolescents With Breakthrough COVID-19 Infections Requiring Hospitalization: A Multicenter Retrospective Study

Background Vaccines have the most important role in the battle against the COVID-19 pandemic. With the widespread use of vaccines, COVID-19 has remarkably declined. Adolescents were vaccinated after approvals for this age group, which was later than adults, and a nationwide vaccination program was implemented in August 2021 in Turkey for adolescents >= 12 years of age. Therefore, we aimed to determine the effects of the COVID-19 nationwide adolescent vaccination program on adolescent hospitalizations due to COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by comparing two periods, including the vaccination period (VP) and the pre-VP (PVP). The second aim of this study is to compare the clinical features and disease severity of vaccine-breakthrough COVID-19 hospitalizations with unvaccinated individuals in the VP. Methods A retrospective multicenter study was conducted to determine and compare the number of hospitalizations due to COVID-19 and MIS-C between the VP (September 1, 2021, to August 31, 2022) and PVP (September 1, 2020, to August 31, 2021). We also compared the characteristics, risk factors, and outcomes of breakthrough infections of adolescents aged 12-18, which required hospitalization with the same age group of unvaccinated hospitalized individuals during the VP. Results During the study period, 3967 children (0-18 years) were hospitalized in the PVP and 5143 (0-18 years) in the VP. Of them, 35.4% were adolescents (12-18 years) in the PVP, and this rate was 18.6% in the VP; relative risk was 0.6467 (95% confidence interval [CI]: 0.6058-0.6904; p 0.001). Patients with breakthrough COVID- 19 were older (201 vs. 175 months, p 0.001) and less commonly hospitalized for COVID-19 (81.5% vs. 60.4%, p 0.001, odds ratio [OR]: 0.347 [95% CI: 0.184-0.654]). The majority of these infections were asymptomatic and mild (32% vs.72.9%: p 0.001, OR: 5.718 [95% CI: 2.920-11.200]), and PICU admission was less frequently required (p = 0.011, OR: 0.188 [95% CI: 0.045-0.793]). Most breakthrough COVID-19 infections occurred within three months after the last vaccine dose (54.2%). Conclusions This study demonstrated a significant decrease in adolescent hospitalizations due to COVID-19 and MIS -C after implementing COVID-19 vaccines in Turkey. Breakthrough cases were less severe and mostly occurred three months after the last dose. This study emphasizes the importance of COVID-19 vaccines and that parents' decisions may be changed, particularly those who hesitate to or refuse vaccination

Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control Covid-19 pandemisinde enfeksiyon kontrol çalışmaları çerçevesinde çocuk hastalarla çalışan sağlık personeli eğitimi

© 2020, AVES. All rights reserved.Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic

SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: A nationwide surveillance.

BACKGROUND: COVID-19 pandemic affected every single person on earth one way or the other. The healthcare personnel were no exception, their responsibilities as well as their risks being immense. METHODS: 4927 healthcare personnel all working in pediatric units at 32 hospitals from seven different regions of Turkey enrolled to the study to determine the seroprevalence of SARS Co-V-2 after the first peak wave. Point of care serologic lateral flow rapid test kit for IgM/IgG was used (Ecotest CE Assure Tech. Co. Ltd.). Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. RESULTS: Nearly 6.1% of healthcare personnel were found to be seropositive for SARS Co-V- 2. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19 co-worker increased the likelihood of infection. The least and the most experienced personnel affected more. Most of the seropositive healthcare personnel (68%) did not have any suspicion that they had COVID-19 previously. CONCLUSIONS: Health surveillance for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission

Evaluation of vaccination status of health care workers for recommended vaccines and their acceptance of SARS-CoV-2 vaccines

© 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.Introduction: Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs’ hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. Method: A short survey was carried out in May–June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. Results: In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. Conclusion: Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs