Heart Rate Variability in Children with Tricyclic Antidepressant Intoxication

The aim of this study was to evaluate HRV in children requiring intensive care unit stays due to TCA poisoning between March 2009 and July 2010. In the time-domain nonspectral evaluation, the SDNN (P<0.001), SDNNi (P<0.05), RMSDD (P<0.01), and pNN50 (P<0.01) were found to be significantly lower in the TCA intoxication group. The spectral analysis of the data recorded during the first 5 minutes after intensive care unit admission showed that the values of the nLF (P<0.05) and the LF/HF ratio (P=0.001) were significantly higher in the TCA intoxication group, while the nHF (P=0.001) values were significantly lower. The frequency-domain spectral analysis of the data recorded during the last 5 minutes showed a lower nHF (P=0.001) in the TCA intoxication group than in the controls, and the LF/HF ratio was significantly higher (P<0.05) in the intoxication group. The LF/HF ratio was higher in the seven children with seizures (P<0.001). These findings provided us with a starting point for the value of HRV analysis in determining the risk of arrhythmia and convulsion in TCA poisoning patients. HRV can be used as a noninvasive testing method in determining the treatment and prognosis of TCA poisoning patients

Peginterferon Treatment In Children: A Review Of Chronic Hepatitis B And Chronic Hepatitis C Treatment

Despite of extensive blood product screening and national immunization programs, chronic hepatitis B and C infections continues to be a global problem with high mortality, morbidity and economic impact. Even though acquisition of these infections mostly occurs in childhood, major problems appear in adulthood. Cirrhosis and HCC are two major expected late events related to chronic hepatitis B and C infections. Rarely, children may also face these complications. To avoid these complications and increase the life expectancy in adults treatment of these two type infections should be started in childhood with appropriate patient selection. In contrast to children, adults are luckier in terms of treatment alternatives. They have the chance to use more potent antivirals with higher genetic barrier and pegylated form of interferons. Recently, the use of pegylated interferon and ribavirin combinations has been approved in children in Chronic HCV infection. However, chronic hepatitis B treatment in children is still dependent on the use of one type antiviral drug and conventional interferon. Treatment in early ages with an antiviral agent that has limited genetic barrier may block the chance of treatment or reduce the response rate in adulthood in chronic hepatitis B infection. This burden indicates the necessity of new therapeutic modalities in children. In this term pegylated interferons may be one of the optiones. In this article we aimed to reviewe the efficacy and safety of conventional and pegylated interferons, for the treatment of Hepatitis C and B infections in children

Evaluation of children with cholelithiasis:10 years of single center experience

Son yıllarda risk faktörlerinde değişiklikler, tanı ve tedavi yöntemlerinde gelişmeler nedeni ile safra taşı tanısıyla izlenen hastaların demografik verileri, başvuru yakınmaları, görüntüleme bulguları, risk faktörleri, tedavi rejimleri ve tedaviye yanıtlarının değerlendirilmesi amaçlanmıştır. Eskişehir Osmangazi Üniversitesi’nde 2008-2018 yılları arasında kolelitiazis tanısı ile izlenen çocukların demografik özellikleri, aile öyküleri, altta yatan hastalıkları, ilaç kullanımları, semptomları, labaratuvar ve görüntüleme bulguları, uygulanan medikal ve cerrahi tedavi yöntemleri kaydedildi. Ursodeoksikolik asit (UDCA) tedavisini en az 6 ay süreyle alanlar tedavi açısından değerlendirmeye alındı ve taşın tamamen kaybolması tedaviye yanıt olarak kabul edildi. 79 çocuk [32 erkek (%40), 47 kız (%60); ortalama 8 yaş 10 ay] çalışmaya alındı. Hastalardan 39’unda (% 49.3) taş oluşumu için bir risk faktörü vardı: En sık obezite (%21.5), daha sonra ilaç (% 17.7, seftriakson) ve hemolitik hastalıklar (% 10.1, 4 herediter sferositoz, 1 G6PD eksikliği, 2 talasemi majör ve 1 orak hücreli anemi) tespit edildi. Hastaların %57’sinde biliyer semptomlar (sağ üst kadran-epigastrik ağrı, bulantı, kusma, sarılık, yağlı besin intoleransı) görülürken, % 43’ü ise asemptomatikti. Toplam 70 hastanın (%88) en az 6 ay UDCA tedavisi (15-20 mg/kg/gün) aldığı ve izlemde 41’inde (%58) taşın kaybolduğu görüldü. On üç hastaya (%16.4, ortalama yaş 145.7±40 ay) kolesistektomi uygulandı. Sonuç olarak çocuklarda kolelitiazisin %50’sinin nedeni belli olmadığı, en sık risk faktörünün obezite olduğu, puberte öncesi ve sonrası bulgularda farklılık olmadığı, sıklıkla semptomatik oldukları, UDCA yanıtlarının yüksek ve özellikle seftriaksona bağlı taşlarda daha belirgin olduğu görüldü.We aimed to evaluate demografic features, symptoms, imaging findings, risk factors, treatment modalities and response to treatment of children with cholelithiasis due to changes in risk factors and development in diagnosis and treatment methods in recent years. This retrospective study was conducted in Eskişehir Osmangazi University School of Medicine Pediatric Gastroenterology and Hepatology Department between January 2008 and December 2018. The ethics committee of Eskişehir Osmangazi University approved the study. Demografic features, symptoms, imaging findings, risk factors, treatment modalities and response to treatment of children with cholelithiasis were recorded. Patients who received UDCA teratment at least for 6 months were enrolled the study. Treatment responce was defined as dissolving of stone completely. Seventy nine children [32 (40%) boys, 47 (60%) girls; mean 8 years and 10 months] were enrolled the study. Among the 79 pediatric patients, 39 patients had at least 1 risk factor [ obesity (21.5%), lithogenic drug (17.7%) ve hemolytic disease (10.1%, 4 hereditary sferocytosis, 1 G6PD deficiency, 2 talassemia major ve 1 sickle cell anemia)]. Fifty seven per cent of patients have biliary symptoms (right upper quadrant pain, nause, vomiting, jaundice and intolerance with fatty meal) while 43% were asymptomatic. Seventy patients were received UDCA therapy at least 6 months and resolution of gallstone was seen in 41 (58%). Thirteen patients (16.4%, mean age 145.7±40 months) were treated by laparoscopic cholecystectomy. As a result, it was observed that 50% of cholelithiasis was not known in children, and the most common risk factor was obesity, and there was no difference between pre- and post-pubertal groups, and they were frequently symptomatic, and UDCA responses were higher and especially in ceftriaxone-dependent stones

Clinical Efficacy Comparison of Saccharomyces boulardii and Yogurt Fluid in Acute Non-Bloody Diarrhea in Children: A Randomized, Controlled, Open Label Study

The purpose of this trial is to evaluate the clinical efficacy and cost/effectiveness of Saccharomyces boulardii compared with yogurt fluid (YF) in acute non-bloody diarrhea in children. This randomized, prospective open-label clinical trial includes 55 children (36 boys, 19 girls; mean age 21.2 ± 28.2 months). Group A (N = 28) received lyophilized S. boulardii and group B (N = 27) received YF. The duration of diarrhea was shorter with S. boulardii but the hospital stay was reduced with YF, although these differences were not significant. However, diarrhea had resolved in significantly more children on day 3 in the S. boulardii group (48.5% versus 25.5%; P < 0.05). In outpatient cases, yogurt treatment was cheaper than S. boulardii whereas in hospitalized patients, treatment cost was similar. In conclusion, the effect of daily freshly prepared YF was comparable to S. boulardii in the treatment of acute non-bloody diarrhea in children. The duration of diarrhea was shorter in the S. boulardii group, expressed as a significantly higher number of patients with normal stools on day 3

Assessing the Knowledge Levels of Pediatricians and Family Physicians Regarding the Eruption Period of Primary Teeth and Oral Health of Children: A Cross-Sectional Study

Purpose: The research aimed to assess the knowledge level of pediatricians and family physicians regarding the eruption period of primary teeth and pediatric oral-dental health. Methods: Pediatricians, research assistants in pediatrics, and family physicians working in Ankara were reached via e-mail and mobile applications. The demographic characteristics of the participants and their level of knowledge on child oral-dental health and primary teeth eruption period were assessed. The questions were formed following the current guidelines (AAPD). The collected data was analyzed by SPSS 24, and p lt;0.05 was accepted for statistical significance. Results: 251 physicians, 67.3% (n=169) of whom were female, participated in the study. The ratio of assistant physicians among the participants is approximately 41%. Nearly 40% of the participants were in the first three years of their profession. A statistically significant relationship was detected between the answers to the questions on the eruption cyst, amber necklace use and the necessity of primary teeth treatments, and the titles of the professionals (p lt;0.05). The rates of correct answers were found to be less in ratio regarding early childhood caries, the differences of oral mucosa in eruption and newborn period, and the relation between fever and teething period. Conclusion: In conclusion, the knowledge level of pediatric and family physicians about the eruption period of primary teeth and oral-dental health was found to be insufficient. Protecting children's oral and dental health is necessary, especially by informing family physicians and pediatricians

Giant Condyloma Acuminate Due Human Papilloma Virus Type 16 In An Infant Successfully Treated With Topical Imiquimod Therapy

Anogenital warts related to human papillomavirus (HPV) have been observed in children. Definition of the transmission mode, therapy, and follow-up for long term potential complications is important. A 27-month old girl was admitted with multiple pedunculated red-purple colored cauliflower-like lesions of 1.5 years duration. Clinical/histopathological and microbiological diagnosis was condyloma acuminate due to HPV type 16. After 12 weeks of imiquimod 5% cream application (pea-sized) overnight three times per week, the perianal warts had completely disappeared. The mode of transmission of HPV 16 in our case was probably horizontal, related to the sharing of common personal hygiene items in the women’s shelter. We report herein the case of an infant living in a women’s shelter with giant condyloma acuminata due to HPV 16, which was successfully treated with topical imiquimod therapy. This patient should be followed up for recurrence and potential malignant lesions related to HPV type 16.PubMedScopu

Clinical Study Heart Rate Variability in Children with Tricyclic Antidepressant Intoxication

The aim of this study was to evaluate HRV in children requiring intensive care unit stays due to TCA poisoning between March 2009 and July 2010. In the time-domain nonspectral evaluation, the SDNN ( &lt; 0.001), SDNNi ( &lt; 0.05), RMSDD ( &lt; 0.01), and pNN50 ( &lt; 0.01) were found to be significantly lower in the TCA intoxication group. The spectral analysis of the data recorded during the first 5 minutes after intensive care unit admission showed that the values of the nLF ( &lt; 0.05) and the LF/HF ratio ( = 0.001) were significantly higher in the TCA intoxication group, while the nHF ( = 0.001) values were significantly lower. The frequency-domain spectral analysis of the data recorded during the last 5 minutes showed a lower nHF ( = 0.001) in the TCA intoxication group than in the controls, and the LF/HF ratio was significantly higher ( &lt; 0.05) in the intoxication group. The LF/HF ratio was higher in the seven children with seizures ( &lt; 0.001). These findings provided us with a starting point for the value of HRV analysis in determining the risk of arrhythmia and convulsion in TCA poisoning patients. HRV can be used as a noninvasive testing method in determining the treatment and prognosis of TCA poisoning patients