An evaluation of children with Kawasaki disease in Istanbul: a retrospective follow-up study

BACKGROUND: Kawasaki disease (KD) is an acute, self-limiting vasculitis of unknown etiology. The incidence of KD is increasing world wide. However, the epidemiological data for KD in Turkey has not been well described. OBJECTIVE: To describe the demographic, clinical, and laboratory features of children with KD who were diagnosed and managed in the American Hospital, Istanbul, Turkey. METHOD: Patients with KD were retrospectively identified from the hospital discharge records between 2002 and 2010. Atypical cases of KD were excluded. A standardized form was used to collect demographic data, clinical information, echocardiography and laboratory results. RESULTS: Thirty-five patients with KD, with a mean age of 2.5 + 1.9 years, were identified. Eighty-five point seven per cent of patients were under 5 years of age. A seasonal pattern favouring the winter months was noticed. In addition to fever and bilateral conjunctival injection, changes in the oral cavity and lips were the most commonly detected clinical signs in our cases. Coronary artery abnormalities were detected in nine patients. The majority of our patients had started treatment with intravenous immunoglobulin in the first 10 days of the onset of fever, and only one patient required systemic steroids for intravenous immunoglobulin-resistant KD. The coronary artery abnormalities resolved in all nine patients within 8 months. CONCLUSION: This study is the most comprehensive series of children from Turkey with KD included in Medline. As adult-onset ischemic heart disease may be due to KD in childhood, further prospective clinical investigations are needed to understand the epidemiology, management and long-term follow-up of the disease

Analysis of the Center for Epidemiologic Studies Depression Scale (CES-D) in Children and Adolescents from the Perspective of the Item Response Theory

Analysis of the Center for Epidemiologie Studies Depression Scale (CES-D) in children and adolescents from the perspective ofthe item response theory.CES-Depresyon Ölcegi'nin çocuk ve ergenlerde kullanimmin madde cevap kurami ile incelenmesi

Bebeklerde ve çocuklarda yaygın fizyolojik sıkıntılar ve davranış sorunları: Birinci basamak hekimlerinin bilmesi gerekenler

While some parents arrive at the physician’s office with concerns about their child’s behavior, others are unaware of their child’s physiological and behavioral problems until they are asked specific questions about their child’s conduct. An understanding of the child’s physiological and temperamental factors, together with an assessment of the settings in which the behaviors occur are critical for the physician to provide a successful treatment plan, as are events preceding the behavior, and consequences of the behavior. Physicians must therefore ascertain potential problems and identify contributing factors in order to recommend specific interventions, or refer the child to the appropriate specialist. This article reviews common physiological and behavioral problems of children so that primary care physicians can effectively aid families in identifying problem behaviors and promoting appropriate behavior

An evaluation of children with Kawasaki disease in Istanbul: a retrospective follow-up study

BACKGROUND: Kawasaki disease (KD) is an acute, self-limiting vasculitis of unknown etiology. The incidence of KD is increasing world wide. However, the epidemiological data for KD in Turkey has not been well described. OBJECTIVE: To describe the demographic, clinical, and laboratory features of children with KD who were diagnosed and managed in the American Hospital, Istanbul, Turkey. METHOD: Patients with KD were retrospectively identified from the hospital discharge records between 2002 and 2010. Atypical cases of KD were excluded. A standardized form was used to collect demographic data, clinical information, echocardiography and laboratory results. RESULTS: Thirty-five patients with KD, with a mean age of 2.5 + 1.9 years, were identified. Eighty-five point seven per cent of patients were under 5 years of age. A seasonal pattern favouring the winter months was noticed. In addition to fever and bilateral conjunctival injection, changes in the oral cavity and lips were the most commonly detected clinical signs in our cases. Coronary artery abnormalities were detected in nine patients. The majority of our patients had started treatment with intravenous immunoglobulin in the first 10 days of the onset of fever, and only one patient required systemic steroids for intravenous immunoglobulin-resistant KD. The coronary artery abnormalities resolved in all nine patients within 8 months. CONCLUSION: This study is the most comprehensive series of children from Turkey with KD included in Medline. As adult-onset ischemic heart disease may be due to KD in childhood, further prospective clinical investigations are needed to understand the epidemiology, management and long-term follow-up of the disease

Toxicological evaluation of two children diagnosed as Munchausen syndrome by proxy

Turkmen Z, Ziyalar N, Tari I, Mercan S, Kayiran SM, Sener D, Cengiz S, Akcakaya N. Toxicological evaluation of two children diagnosed as Munchausen syndrome by proxy. Turk J Pediatr 2012; 54: 283-286