Chest Imaging Findings in Hospitalized Children with H1N1 Influenza

Objective: The aim was to review the radiological findings and to find new prognostic factors that determine the need for pediatric intensive care unit (PICU) in children with swine-origin influenza (H1N1) virus infection. Methods: Chest X-ray (CXR) and computed tomography (CT) findings of 18 children with laboratory-confirmed H1N1 infection (9 boys, 9 girls) with a median age of 34 (1–216) months were retrospectively evaluated. Results: CXRs were performed in 15 (83.3%) and thorax CT in 7 (38.8%) children. Abnormal findings were detected in 60% of the patients who underwent CXR and 85.7% of the patients who underwent thorax CT. Radiological findings were mostly diffuse, bilateral, and asymmetric. Ground-glass opacity (GGO) (66.6%) was the leading abnormality and was followed by reticulation (38.8%), nodules (27.7%), consolidation only (16.6%), tree-in-bud pattern (11.1%), consolidation with GGO (5.5%), and septal lines (5.5%). Lymphadenopathy (22.2%), air trapping (5.5%), and parenchymal band (5.5%) were other recorded findings. CXR was found to be insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. Only existence of nodules (p=0.04) affected the need for PICU admission. Conclusion: The most common radiological findings in children with H1N1 infection were bilateral, asymmetric GGO with or without associated multifocal areas of consolidation. CXR was insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. The existence of nodules is a bad prognostic factor in determining the need for PICU admission

Clinical and laboratory evaluation of Turkish children with IgG subclass deficiency

MakaleWOS:000922080700001PubMed ID: 36089538Background: IgG subclass deficiency is a laboratory diagnosis and becomes important with recurrent infections. This study aimed to examine the demographic, clinical, and laboratory results of pediatric cases with IgG subclass deficiency and to improve the understanding of the clinical significance of IgG subclass deficiency. Methods: In this study, the clinical and laboratory features of 111 pediatric patients, with at least one whose serum IgG subclasses was measured as lower than 2 standard deviation of healthy aged-matched control values, were evaluated. The clinical and laboratory features of the cases with isolated IgG subclass deficiency (Group 1) and those with low serum levels of any of IgG, IgA, and IgM in addition to the IgG subclass deficiency (Group 2) were compared. Results: A total of 55 (49.54%) and 56 (50.45 %) patients were included in Groups 1 and 2, respectively. Among our studied cases, 20 (18. 1%) had a history of hospitalization in the neonatal period, 61 (54.95 %) had at least one hospitalization due to infection, and 55 (49.54%) had a history of recurrent infection. The frequencies of these three conditions were statistically significantly higher in Group 2 (p < 0.05). The frequencies of infections in the last year in Groups 1 and 2 were 4.4 +/- 1.2 and 5.4 +/- 1.9, respectively (p < 0.05). As a result of recurrent infections, 43.24% (n = 48) of our patients received antibiotic prophylaxis, and 21.62% (n = 24) had immunoglobulin replacement therapy. Furthermore, the numbers of pa-tients who needed these treatments were higher in Group 2 (p < 0.05).Conclusion: In cases with IgG subclass deficiencies, concomitant main-group immunoglobulin deficiencies may increase the number and severity of infections, leading to hospitalizations, antibiotic prophylaxis, and immunoglobulin therapy. More attention should be paid to cases of immunoglobulin main-group deficiencies in the follow-up of these cases.Copyright (c) 2022, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/)

Results of treatment in our patients with toxic epidermal necrolysis

Giriş: Toksik epidermal nekroliz, nadir görülmesine rağmen mortalite ve morbiditesi oldukça yüksek bir hastalıktır. Hastalığın mortalitesi yüksek olmasına rağmen, tedavisi günümüzde halen tartışmalıdır. Bu çalışmada hastanemizde toksik epidermal nekroliz nedeniyle izlenen hastaların tedavi sonuçları değerlendirildi. Gereç ve Yöntem: Toksik epidermal nekroliz tanısıyla hastanemizde Ocak 2011-Nisan 2013 yılları arasında karşılaştığımız çocuk hastaların verilen tedavilere cevapları dosya kayıtlarından retrospektif olarak incelendi. Bulgular: İki yıllık süre içinde toksik epidermal nekroliz tanısıyla beş çocuk olgu izlenmiştir. Olguların ortanca yaşı 9 yaş (en küçük: 2 yaş, en büyük: 15 yaş) olup, üç olgu erkekti. Üç olguda antikonvülzan kullanımı sonrası, bir olguda antibiyotik sonrası, bir olguda ise antihipertansif kullanımı sonrası toksik epidermal nekroliz tablosu gelişti. Üç olguda, beş gün süreyle 1 g/kg intravenöz immünglobulin (İVİG) ve 1 mg/kg/ gün dozunda kortikosteroid tedavisi kombine olarak verilirken, iki olguda, beş gün süreyle 1 g/kg/gün dozunda İVİG tedavisi tek başına verildi. İki hastamızda kortikosteroid tedavisi beş gün verildi. Bir hastamızda ise, kortikosteroid tedavisi yedi gün verildi. Hastalığın mortalitesini gösteren SCORTEN’e göre daha şiddetli lezyonları olan bu olgunun izleminde gram-negatif sepsis gelişti. Özellikle antikonvülzan sonrası toksik epidermal nekroliz gelişen olguların daha ağır seyrettiği ve iyileşme sürelerinin daha uzun olduğu gözlendi. Sonuç: Hastalarımızın tamamında iyileşme gözlendi. Tek başına İVİG tedavisinin, kortikosteroid ve İVİG kombinasyonu tedavisiyle kıyaslandığında tedavi uygulamalarının sonuçları arasında fark görülmedi.Objective: Toxic epidermal necrolysis is a rare disease that has very high mortality and morbidity. Despite the high mortality rate of the disease, treatment is still controversial today. In this study, we discussed the treatment of patients who were treated and followed up due to the toxic epidermal necrolysis in our hospital. Materials and Methods: This is a s tudy of children diagnosed as toxic epidermal necrolysis in our hospital between January 2011 and April 2013. We retrospectively analyzed response to the treatment. Results: We followed five patients in this period with a clinical diagnosis of toxic epidermal necrolysis. The median age at diagnosis was nine years (min: 2, max: 15), and three of them were male. Toxic epidermal necrolysis occured in three of the patients after the use of anticonvulsants, in one of the patients after use of antibiotic and in one of the patients after the use of antihypertensive. Three of the patients were given combination of intravenous immunoglobulin (IVIG) (1 g/kg) with corticosteroid (1 mg/kg/day), two of the patients only were given IVIG (1 g/kg/day). In two patients, corticosteroid therapy was given for five days. In one case who was given corticosteroid therapy for seven days and with lesions more severe according to SCORTEN developed gram-negative sepsis in clinical follow. Especially patients developed toxic epidermal necrolysis after anticonvulsant showed more severe clinic and longer recovery period. Conclusion: Improvement was observed in all patients. When only IVIG therapy compared to corticosteroid plus IVIG treatment, there were no superiority to each other

Chest Imaging Findings in Hospitalized Children with H1N1 Influenza

Objective: The aim was to review the radiological findings and to find new prognostic factors that determine the need for pediatric intensive care unit (PICU) in children with swine-origin influenza (H1N1) virus infection. Methods: Chest X-ray (CXR) and computed tomography (CT) findings of 18 children with laboratory-confirmed H1N1 infection (9 boys, 9 girls) with a median age of 34 (1–216) months were retrospectively evaluated. Results: CXRs were performed in 15 (83.3%) and thorax CT in 7 (38.8%) children. Abnormal findings were detected in 60% of the patients who underwent CXR and 85.7% of the patients who underwent thorax CT. Radiological findings were mostly diffuse, bilateral, and asymmetric. Ground-glass opacity (GGO) (66.6%) was the leading abnormality and was followed by reticulation (38.8%), nodules (27.7%), consolidation only (16.6%), tree-in-bud pattern (11.1%), consolidation with GGO (5.5%), and septal lines (5.5%). Lymphadenopathy (22.2%), air trapping (5.5%), and parenchymal band (5.5%) were other recorded findings. CXR was found to be insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. Only existence of nodules (p=0.04) affected the need for PICU admission. Conclusion: The most common radiological findings in children with H1N1 infection were bilateral, asymmetric GGO with or without associated multifocal areas of consolidation. CXR was insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. The existence of nodules is a bad prognostic factor in determining the need for PICU admission

Chest Imaging Findings in Hospitalized Children with H1N1 Influenza

The aim was to review the radiological findings and to find new prognostic factors that determine the need for pediatric intensive care unit (PICU) in children with swine-origin influenza (H1N1) virus infection.Methods: Chest X-ray (CXR) and computed tomography (CT) findings of 18 children with laboratory-confirmed H1N1 infection (9 boys, 9 girls) with a median age of 34 (1-216) months were retrospectively evaluated. Results: CXRs were performed in 15 (83.3%) and thorax CT in 7 (38.8%) children. Abnormal findings were detected in 60% of the patients who underwent CXR and 85.7% of the patients who underwent thorax CT. Radiological findings were mostly diffuse, bilateral, and asymmetric. Ground-glass opacity (GGO) (66.6%) was the leading abnormality and was followed by reticulation (38.8%), nodules (27.7%), consolidation only (16.6%), tree-in-bud pattern (11.1%), consolidation with GGO (5.5%), and septal lines (5.5%). Lymphadenopathy (22.2%), air trapping (5.5%), and parenchymal band (5.5%) were other recorded findings. CXR was found to be insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. Only existence of nodules (p0.04) affected the need for PICU admission.Conclusion: The most common radiological findings in children with H1N1 infection were bilateral, asymmetric GGO with or without associated multifocal areas of consolidation. CXR was insufficient to detect subpleural nodules, lymphadenopathies, and sometimes GGO. The existence of nodules is a bad prognostic factor in determining the need for PICU admissio

Evaluation of the Demographical and Clinical Characteristics of the Children with Foreign Body Aspiration: A Single Center Experience

Objective: To evaluate the determination of demographic and clinical characteristics and the roles of parental education and income levels in foreign body aspirations in childhood. Methods: Seventeen patients who admitted to the Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Pulmonology for foreign body aspirations and from whom the body is taken out were evaluated retrospectively, and compared with the demographic features of 60 matched healthy children with the same age and gender. Results: The mean age of the patients was 14.9±4.8 months, and of the patients 9 (53%) were males. The most common symptoms at admission were sudden onset of cough (76.5%) and wheezing (64.7%), while sunflower peel (47%) was the most commonly detected foreign body. Difference in lung aeration was the most common finding (76.5%) in radiological imagings, and foreign bodies were mostly removed from right bronchus (47%). While 76.5% of the patients had 5 or more households, this ratio was 46.6% in control group (p=0.008). Income level of patient group was significantly lower compared to control group (p=0.02). The rate of mothers who did not have high school and/or university education was higher (94.1%) than the control group (63.3%) (p=0.02). Conclusion: Foreign body aspiration should be the first reason to be thought when there is a sudden onset of cough and wheezing in a child. Low socioeconomic level, to be in a crowded family and low education level of the mother should be evaluated among risk factors for foreign body aspirations

Yabancı Cisim Aspirasyonu olan Çocukların Demografik ve Klinik Verilerinin İncelenmesi: Tek Merkez Deneyimi

Amaç: Yabancı cisim aspirasyonu tespit edilen çocukların, demografik ve klinik özelliklerinin belirlenmesi, ebeveyn eğitim düzeyleri ve gelir seviyesi ile olan ilişkilerinin değerlendirilmesi planlanmıştır. Yöntemler: Çalışmamızda, Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Çocuk Göğüs Hastalıkları bölümüne aspirasyon nedeniyle başvuran ve yabancı cisim çıkartılan 17 hasta çocuğun retrospektif verileri ile aynı yaş ve cinsiyet dağılımına uyan 60 sağlıklı çocuğun demografik özellikleri değerlendirildi. Bulgular: Hastaların yaş ortalaması 14,94,8 ay olup, hastalardan 9'u (%53) erkekti. En sık başvuru şikayeti ani başlayan öksürük (%76,5) ve hışıltı (%64,7) iken, çekirdek (%47) en sık tespit edilen yabancı cisim oldu. Radyolojik incelemede en sık bulgu havalanma farkı (%76,5) iken, cisimler en sık sağ ana bronştan (%47) çıkarıldı. Hasta grubunda bir evde 5 ve üstünde kişi yaşama yüzdesi %76,5 iken, kontrol grubunda %46,6 idi (p0,008). Hasta grubunun gelir düzeyi kontrol grubuna göre belirgin olarak düşüktü (p0,02). Lise ve/veya üniversite eğitimi almamış anne oranı (%94,1), kontrol grubundaki annelere oranla (%63,3) daha yüksekti (p0,03). Sonuç: Bir çocukta ani başlayan öksürük ve hışıltı geliştiği durumlarda yabancı cisim aspirayonu akla gelmelidir. Düşük gelir, kalabalık aile ortamı ve annenin düşük eğitim düzeyi yabancı cisim aspirasyonu açısından önemli risk faktörleri arasında değerlendirilmelidirObjective: To evaluate the determination of demographic and clinical characteristics and the roles of parental education and income levels in foreign body aspirations in childhood.Methods: Seventeen patients who admitted to the Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Pulmonology for foreign body aspirations and from whom the body is taken out were evaluated retrospectively, and compared with the demographic features of 60 matched healthy children with the same age and gender.Results: The mean age of the patients was 14.9±4.8 months, and of the patients 9 (53%) were males. The most common symptoms at admission were sudden onset of cough (76.5%) and wheezing (64.7%), while sunflower peel (47%) was the most commonly detected foreign body. Difference in lung aeration was the most common finding (76.5%) in radiological imagings, and foreign bodies were mostly removed from right bronchus (47%). While 76.5% of the patients had 5 or more households, this ratio was 46.6% in control group (p0.008). Income level of patient group was significantly lower compared to control group (p0.02). The rate of mothers who did not have high school and/or university education was higher (94.1%) than the control group (63.3%) (p0.02).Conclusion: Foreign body aspiration should be the first reason to be thought when there is a sudden onset of cough and wheezing in a child. Low socioeconomic level, to be in a crowded family and low education level of the mother should be evaluated among risk factors for foreign body aspiration

A family screening of CD19 gene mutation by PCR-RFLP

Introduction and aim. Mutation(s) in the gene encoding the CD19 molecule affect CD19 protein expression and primary immunodeficiency (PID) occurs. The PCR-RFLP method, which is faster and cheaper than other mutation detection methods, is rarely used in the diagnosis of PID. The study aimed to genetically identify CD19 deficiency, which is a PID, using the PCR-RFLP method. Material and methods. A total of 8 patients and two healthy controls were included in the study and the relevant region genotypes in the CD19 gene were determined by performing PCR-RFLP analysis. Results. The index case, newborn baby and mother were also included in the study. It was determined that the index case (P6) was homozygous mutant, the newborn baby (P7) and mother (P8) had heterozygous genotype. Based on this situation, one child (P1) was found to be homozygous mutant, mother (P2), father (P3) and other children (P4 and P5) had heterozygous genotype in the family, which was determined to be related to the first case. Conclusion. In our study, it has been shown that PCR-RFLP is a method that can be used in the diagnosis of PID by determining genotypes using PCR-RFLP, and especially in terms of rapid genetic testing of family screenings