The Role of Bronchoscopy in Childhood Foreign Body Aspirations: A 3-year Experience

Introduction:The purpose of our retrospective study was to define the clinical and radiological features of patients with aspirated foreign bodies, characterize the incidence of foreign body aspiration (FBA) and to compare the results of early and late bronchoscopy.Methods:We reviewed the medical records of patients who were admitted to the pediatric emergency department of our center due to FBA between 2016 and 2018.Results:Forty-four patients (M/F 30/14) aged 38.7±44.1 months (mean ± standard deviation, range: 5-191) were enrolled in this study. The most common symptoms were cough (42/44) and wheezing (20/44). No foreign body was detected in eight patients (18%). Regarding the types of foreign bodies, an organic material was observed in 27 (61.4%) patients with FBA, and a nonorganic material was observed in 9 (20.5%) patients. The mean age of patients with organic FBA was significantly lower than that of patients with non-organic FBA (26±18 vs. 93±67 months, p=0.005).Conclusion:Bronchoscopy is an efficient diagnostic tool for patients with suspected FBA because it is associated with low complication risk and reduces the risks of delayed FBA diagnosis and treatment

Clinical and Cytokine Profile of Children With COVID-19: A Report From Turkey

Background We aimed to analyze the expression of infection-related biomarkers and inflammatory cytokines in laboratory-confirmed cases and compare the differences between clinically severe and non-severe ones. Method We randomly selected 35 patients who were hospitalized with the diagnosis of coronavirus disease 2019 (COVID-19). Blood serum was obtained at the time of admission to the hospital, on the third to the fifth day, and at the time of discharge. Result The median age of our patients was 56.5±69.7 months (range: 1-205 months). The mean pro-B-type natriuretic peptide (pro-BNP) was significantly higher at the time of admission than on the third to the fifth day of illness. The mean pro-B-type natriuretic peptide levels at three time points were significantly higher in patients with severe cases than in mild-moderate cases. However, there was no significant difference between the clinical severity with regard to the cytokine levels at disease onset and recovery. Conclusion In the study, it was shown that cytokines play an important role in the pathogenesis of COVID-19. Therefore, it may be beneficial to use agents such as tocilizumab in the treatment

Comparison of the Effectiveness of Topical and Oral Beta Blockers in the Treatment of Childhood Hemangiomas

Purpose: Hemangiomas are the most common vascular tumors in childhood, and the treatment options have undergone profound changes in recent years. In this study, we aimed to compare the efficacy and safety of beta-blockers on hemangiomas, both topi-cal and oral, with non-pharmacological treatment in the pediatric age group. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with hemangiomas. Results: Fifty-three patients (F/M=40/13) were enrolled in this study. Superficial hemangiomas were detected in 14 (26.4%) patients, and deep hemangiomas were detected in 39 (73.6%) patients. Seventeen patients were followed without medication, 19 were treated with a topical beta blocker, and 17 were treated with an oral beta blocker. Twelve patients with superficial hemangi-omas were followed without medication, while two received topical timolol treatment. A comparison of lesion progression in patients with superficial hemangiomas in the non-pharmacological treatment and topical treatment groups showed that the mean scores of success, in terms of mean fading and reduction in lesion depth, were significantly higher at the first month (7.0 vs. 1.66; p=0.049; 6.0 vs. 1.5; p=0.045). Among patients with deep hemangiomas, a comparison of mean fading scores showed no difference between the oral and topical treatment groups in the first and fourth months (p=0.551, p=0.551). Conclusion: We believe that oral beta-blockers can be used instead of topical treatment in the future, and they will be preferred more by clinicians and families due to less side effects

Evaluation the role of urinary KIM-1, NGAL and IL-18 levels in determining the early renal injury in cases of Hypercalciuria and / or renal calculi in pediatric patients.

Böbrek disfonksiyonunu ve tübül hasarının erken tesbitinde idrar enzim ve proteinleri de ölçülebilmektedir. Bu enzim ve proteinlerin başlıcaları; Glutatiyon S-transferaz, glutamil transferaz, atrial natriüretik peptid, laktat dehidrogenaz, N-asetil -D-glukozaminidaz (NAG), fruktoz-1,6-bifosfataz, Ala-(Leu-Gly)-aminopeptidaz, idrar düşük molekül ağırlıklı proteinleri (alfa-1 ve beta-2 mikroglobulin, retinol-bağlayıcı protein, sistatin C), NGAL(Neutrophil gelatinase-associated lipocalin), İL-18 (İnterlökin 18), böbrek hasarı molekülüdür (kidney injury molecule-1: KİM1). Bu çalışmada hiperkalsiürisi ve/veya böbrek taşı olan hastalarda, böbrek tübül hasarını erken dönemde tanımlayabilecek NGAL, İL-18, KİM1 gibi erken hasar belirteçlerinin düzeyini değerlendirip sağlıklı bireylerinki ile karşılaştırmayı amaçladık. Çalışmamızda 63 nefrolitiazis(NL) ve/veya hiperkalsiüri(HK) hastası ve 20 kontrol grubu bireylerinden alınan idrar örneklerinde NGAL, KİM-1, İL-18 düzeyleri analizi yapıldı. Grupların birbirleri ile olan karşılaştırmasında NL grubu hastaların idrar NGAL/kr düzeyleri kontrol grubundan anlamlı olarak yüksek bulundu (p=<0,001). İL-18/kr ve KİM 1/kr düzeylerinin hasta grupları ile kontrol grubu karşılaştırmalarında, anlamlı farklar bulunmadı. NL grubunda hiperkalsiüri varlığı, HK grubunda yüksek kalsiyum atılımı açısından yapılan değerlendirmelerde bu erken hasar belirteçleri açısından kontrol ve hasta grupları arasında fark saptanmadı NGAL, erken proksimal tübül hasarı tesbiti için uygun bir belirteç olarak kullanılabilir. Bu hasta gruplarında idrar NGAL düzeylerinin değerlendirildiği ve anlamlı sonuçlar alınan ilk çalışma olması, çalışmamızı özgün kılmaktadır.To determine of renal dysfunction and renal tubular injury earlier, urinary enzymes and protein be able to measured. The major of these enzyme and proteins are Glutation S-transferase, glutamyl transferase, atrial natriuretik peptide, laktat dehidrogenase, N-acetyl -D-glucosaminidase (NAG), fructose-1,6-biphosphotase, Ala-(Leu-Gly)-aminopeptidase, urinary low molecular weight proteins (alfa-1 ve beta-2 microglobulin, retinol-binding protein, cystatin C) NGAL (neutrophil gelatinase-associated lipocalin), İL-18 (Interleukin 18), KIM-1 (kidney injury molecule-1) subsequently. The aim of this study is to evaluate the role of urinary KIM-1, NGAL and IL-18 levels in determining of early renal injury in cases of hypercalciuria and / or nephrolithiasis in pediatric patients and to compare with that of healthy subjects. Urine NGAL, KIM- 1, IL- 18 levels were measured in 63 child patients diagnosed with nephrolithiasis(NL) and/or hypercalciuria(HC) and in 20 healthy controls. Significant difference was found for urinary NGAL/cr (p<0.001), between NL patients and healthy children. No significant differences were found in comparison with each other between patient and control groups for urinary IL18/cr and KIM1/cr levels. No significant difference was observed in terms of the high calcium excretion in HC group and presence of hypercalciuria in NL group for these early renal tubular injury biomarkers. We found that urinary KIM 1 and İL-18 measurements were not useful for analyzing renal tubular damage in nephrolitiasis and hypercalciuria. We found that urine NGAL, is a useful parameter to monitor the early proximal tubule damage. To our knowledge significantly increased urinary NGAL levels in nephrolitihiasis and hypercalciuria have been observed for the first time in the literature

Assessment of Children Exposed to Maras Powder Intoxication

Introduction: A smokeless tobacco known as Maras powder (MP) is commonly consumed in the southern region of Turkey. To the extent of our knowledge, no previous study in literature has reported acute MP intoxication in children. Aim: Our aim was to determine the clinical effects and treatment strategies of MP poisoning in children.Materials and methods: We retrospectively reviewed the medical records of children <18 years of age with MP intoxication who were followed up in the Intensive Care Unit between January 2016 and April 2018 in our center. Results: Forty-one patients (M/F= 25/16) were included in this study. The mean age was 13.2±22.4 months (age range: 7 to 30 months). The patients presented with vomiting (n=23, 56%), cough (n=17, 41.5%), loss of consciousness (n=11, 26.8%), respiratory distress (n=6, 14.6%), convulsion (n=7, 17%), cyanosis (n=1, 2.4%), and abdominal pain (n=1, 2.4%) following oral ingestion of the substance. On their physical examination all patients with convulsion were in a comatose state. Thirty-two patients (78%) had tachycardia; 15 patients (36.5%) had pharyngeal hyperemia; and three (7.3%) had hiccups. Although the female patients had a lesser rate of symptoms than male patients, the difference was not statistically significant. Conclusions: Our aim was to inform the doctors about the clinical picture that develops after taking this substance and contribute to the understanding of the treatment approach

Cerebral Vasculitis in Henoch-Schönlein Purpura: A Case Report.

Henoch-Schönlein purpura is a common form of systemic small vessel vasculitis in childhood. Although headache and behavioral changes have been described in a significant proportion of children with Henoch-Schönlein purpura, severe neurological complications are rare. In this article, we report a case of central vasculitis in a four-year-old boy who presented with hemiplegia and aphasia. The treatment options for cerebral vasculitis of Henoch-Schönlein purpura are numerous but controversial in pediatric patients. Our patient was successfully treated by pulse methylprednisolone and pulse cyclophosphamide. The patient was followed-up for four years without any sequel

Effect of the timing of dialysis initiation on left ventricular hypertrophy and inflammation in pediatric patients

Background The optimal time for dialysis initiation in adults and children with chronic kidney disease remains unclear. The aim of this study was to evaluate the impact of dialysis timing on different outcome parameters, in particular left ventricular (LV) morphology and inflammation, in pediatric patients receiving peritoneal dialysis and hemodialysis