Evaluation of Children with Congenital Heart Disease Hospitalized with the Diagnosis of Lower Respiratory Tract Infection

WOS: 000429850300006Aim: Lower respiratory tract infections are an important reason for mortality and morbidity in children with congenital heart disease. This study aimed to evaluate 50 children who had congenital heart disease and were hospitalized with lower respiratory tract infection in the Ege University Faculty of Medicine Pediatrics Hospital. Materials and Methods: Fifty pediatric patients were taken into the study. Their clinical symptoms, acute phase reactants, chest X-rays, bacterial culture of transtracheal aspirate, respiratory virus panel (with multiplex polimerase chain reaction) from nasopharyngeal swab were examined. The groups were evaluated in terms of age, gender, enviromental smoke exposure, living with school-aged siblings, Respiratory Syncytial virus (RSV) prophylaxis, hospitalization time, causative pathogen, additional risk factors. Results: Of the 50 cases, 12 (24%) were cyanotic, 38 (76%) were acyanotic. There were 26 boys and 24 girls. The most common diagnosis in the acyanotic group was hemodynamically significant VSD (isolated or with other diagnoses) with 20 cases. The average age of the cyanotic group was 23.88 +/- 28.81, and the acyanotic group was 12.25 +/- 15.45 months old. Hospitalizations most frequently occured in winter. The most frequent viral agent was RSV, which was not seen in the cyanotic group. All of the RSV infected patients were under 12 months old. In 16.7% of cyanotic and 52.6% of acyanotic patients there were extra risk factors such as immune deficiency, Down syndrome, prematurity, Di George syndrome, cerebral palsy, postoperative early period. Three cases lost their lives due to severe respiratory failure. There was no statistically significant difference between the two groups when compared for demografic variables, risk factors, causative pathogens, hospitalization times. Conclusion: Lower respiratory tract infections and especifically RSV pneumonia are important causes of mortality and morbidity in patients diagnosed with congenital heart disease. To prevent risk factors, more studies must be done

Autoimmune hepatitis and long-term disease course in children in Turkey, a single-center experience

WOS: 000379310600012PubMed ID: 27254777Introduction The aim of this study is to determine clinic and laboratory features, treatment protocols, treatment responses, and long term follow-up of children with autoimmune hepatitis (AIH) in a region of Turkey followed at Ege University. Materials and methods The records of 47 children with AIH between 1998 and 2012 were retrospectively analyzed for clinical profiles, treatment response, relapse rate, and long-term side effects. Results The median age of the children was 10 +/- 4.1 years (55.3% females). A total of 29 patients presented with chronic hepatitis (61.7%). According to the autoantibody profiles, 40 (85.1%) and seven (14.9%) cases were classified as type 1 and type 2, respectively. Presentation with acute hepatitis and chronic hepatitis was significantly higher in type 1 disease. Laboratory findings at presentation was found similar among races as well as AIH types (P>0.05). The prednisolone was used for remission induction in 37 patients; 86.4% (n: 32) achieved a complete response, 2.7% (n: 1) achieved a partial response, and four patients (10.8%) showed no response. Maintenance was attained by low-dose steroid plus thiopurine and relapse in steroid responders (n: 32) was 9.4% (n: 3) at 8, 12, and 48 months. A total of 36% (n: 24) had neither acute nor chronic treatment side effects. Bone marrow suppression was observed in five patients and hyperglycemia was observed in one patient (10.6 and 2.1%), respectively. Conclusion AIH type 1 prevails in children in a region of Turkey during the second decade of life. Low-dose corticosteroids combined with azathioprine are found. Eur J Gastroenterol Hepatol 28:927-930 Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved