Evaluation of Pediatric Immune Thrombocytopenia (ITP) Cases and Risk Factors for Chronic ITP - Single Center Experience

Aim: Immune thrombocytopenia (ITP) is the most common acquired bleeding disorder in childhood. The study aimed to assess the demographic and clinical characteristics, and treatment responses and to evaluate their effects on chronicity in pediatric ITP cases. Material and Methods: Primary ITP patients aged 1 month to 18 years, who were diagnosed and followed up in the Pediatrics Clinic of Tokat Gaziosmanpaşa University Hospital between January 2010 and December 2018, were retrospectively analyzed. Results: Thirty-eight patients with a diagnosis of primary ITP were included in the study. The mean age of the patients was 94.3±53.4 (14-199) months. The female/male ratio was 1. Twenty (57.1%) patients had acute ITP, and 15 (42.9%) patients had chronic ITP. There was no significant difference between the acute ITP group and the chronic ITP group in demographic, clinical features, laboratory findings, and treatment responses. In the first 12 months, the number of admissions with a platelet count o

Çocukluk çağında idiyopatik spontan bilateral adrenal kanama

Adrenal hemorrhage occurs most frequently in the newborn, but it has been also well documented in older children and adults. There are several reasons in etiology and clinical symptoms can vary widely depending on the residual adrenal function. In this case; despite bilateral massive adrenal hemorrhage, no etiologic factor had been found and adrenal insufficiency was not present. To our knowledge, our patient is a spontaneous idiopathic bilateral massive adrenal hemorrhage case without adrenal insufficiency which is the first one reported in a pediatric patient in literature.Adrenal kanama çoğunlukla yenidoğan döneminde görülse de daha büyük çocuklarda ve erişkinlerde de olabilmektedir. Etiyolojide birçok neden rol oynamakta ve klinik bulgu ve belirtiler çeşitlilik gösterebilmektedir. Sunulan vakada masif adrenal kanamaya rağmen adrena yetersizlik gözlenmemiş ve herhangi bir etiyolojik faktör bulunamamıştır. Bilgilerimize göre literatürdeki çocukluk çağında spontan idyopatik bilateral masif adrenal kanaması olan ancak adrenal yetersizlik gelişmeyen ilk vaka olma özelliğini taşımaktadır

Çocukluk çağında idiyopatik spontan bilateral adrenal kanama

Adrenal kanama çoğunlukla yenidoğan döneminde görülse de daha büyük çocuklarda ve erişkinlerde de olabilmektedir. Etiyolojide birçok neden rol oynamakta ve klinik bulgu ve belirtiler çeşitlilik gösterebilmektedir. Sunulan vakada masif adrenal kanamaya rağmen adrena yetersizlik gözlenmemiş ve herhangi bir etiyolojik faktör bulunamamıştır. Bilgilerimize göre literatürdeki çocukluk çağında spontan idyopatik bilateral masif adrenal kanaması olan ancak adrenal yetersizlik gelişmeyen ilk vaka olma özelliğini taşımaktadır

Evaluation of babies with viral lower respiratory tract infections in neonatal intensive care unit

Giriş: Alt solunum yolu enfeksiyonları (ASYE); tüm dünyada çocukluk çağında hastaneye yatış gerektiren ve mortaliteye sebep olan nedenlerin başında gelmektedir. Bu çalışmanın amacı; viral ASYE tanısıyla yenidoğan yoğun bakım ünitesinde (YYBÜ) izlenen hastaların özelliklerinin değerlendirilmesi, viral etkenlerin ortaya konulması ve risk faktörlerinin araştırılmasıdır. Gereç ve Yöntem: Bu çalışmada; bir üniversite hastanesinde 3. basamak YYBÜ’ye Ocak 2018 ve Mart 2020 tarihleri arasında takip ve tedavi için yatırılıp viral ASYE tanısı koyulan hastaların özellikleri ve solunum yolu viral paneli sonuçları geriye dönük olarak incelendi. Hastalar RSV (+) saptananlar ve RSV-dışı viral etken saptanalar olmak üzere iki gruba ayrıldı ve gruplar karşılaştırıldı. Bulgular: Çalışmaya 24 hasta dahil edildi. SYVP sonuçlarında 6 (%25) hastada RSV-A, 8 (%33,3) hastada RSV-B, 10 (%41,6) hastada RSV dışı viral etkenler saptandı. RSV saptanan hastalar ile RSV dışı etkenlerin saptandığı hastalar arasında sosyo demografik özellikler açısından fark bulunmazken; RSV saptanan grupta akciğer grafisinde infiltrasyon varlığı (pnömoni) daha fazla, solunum ya da oksijen desteği alma oranı daha yüksek ve ortalama yatış süresi daha uzun olarak saptandı (p değerleri sırasıyla 0,001, 0,001 ve 0,017). Yatış süresi ile C-reaktif protein düzeyi arasında pozitif yönde, orta düzeyde korelasyon saptandı (r=0,558, p=0,005). Sonuç: YYBÜ’de viral ASYE’de en sık etken RSV olarak bulunmuştur. Bu nedenle YYBÜ’de çalışanların hijyen kurallarına çok dikkat etmeleri ve ziyaretçilerin de bu konuda ciddi şekilde eğitildikten sonra YYBÜ ortamına alınmaları vurgulanmalıdır. Viral ASYE düşünülen hastalarda erken tanı-tedavi yapılabilmesi ve hastalığın yayılımının önlenebilmesi için viral testlere ulaşımın artırılması ve testlerin yaygınlaştırılması önem arz etmektedir.Introduction: Lower respiratory tract infections (LRTIs) are one of the leading cause of hospitalization and mortality in childhood worldwide. The aim of this study was to evaluate the characteristics of the patients hospitalized in the neonatal intensive care unit (NICU) with the diagnosis of viral LRTI, to reveal the viral agents and to investigate the risk factors. Materials and Methods: In this study; the characteristics and the respiratory tract viral panel results of the patients who were hospitalized in the NICU of a university hospital between January 2018 and March 2020 with the diagnosis of viral LRTI were examined retrospectively. The patients were divided into two groups as RSV (+) and non-RSV viral agents, and the groups were compared.Results: 24 patients were included in the study. RSV-A was detected in 6 (25%), RSV-B in 8 (33.3%), and non-RSV viral agents in 10 (41.6%) patients. There were no significant difference between the sociodemographic features of RSV (+) group and non-RSV group. However presence of infiltration on chest radiography (pneumonia) was more common, the rate of receiving respiratory or oxygen support was higher and hospitalization duration was longer in RSV (+) group compared to non-RSV group (p values 0.001, 0.001 and 0.017, respectively). There was a positively, moderate level correlation between hospitalization duration and C-reactive protein (r = 0.558, p=0.005). Conclusions: RSV was the most common agent in viral LRTI in NICU, it should be emphasized that the staff in the NICU should pay close attention to the hygiene rules and that the visitors should be taken into the NICU after they are educated on this issue. It is important to increase the access to viral tests and provide wider use in order to make early diagnosis and treatment in viral LRTI and to take the necessary measures for preventing spread of the disease

Effects of adipose and bone marrow-derived mesenchymal stem cells on vaginal atrophy in a rat menopause model

Background & objectives: Vaginal atrophy is characterized by thinning of vaginal epithelial layers and decreased local blood flow. We aimed to evaluate the regenerative effects of Adipose derived mesenchymal stem cells (ADMSC) and Bone marrow derived mesenchymal stem cells (BMDSC) on vaginal atrophy in rat menopause model

G-protein-coupled estrogen receptor-30 gene polymorphisms are associated with uterine leiomyoma risk

The G-protein-coupled estrogen receptor (GPR30, GPER-1) is a member of the G-protein-coupled receptor 1 family and is expressed significantly in uterine leiomyomas. To understand the relationship between GPR30 single nucleotide polymorphisms and the risk of leiomyoma, we measured the follicle-stimulating hormone (FSH) and estradiol (E2) levels of 78 perimenopausal healthy women and 111 perimenopausal women with leiomyomas. The participants’ leiomyoma number and volume were recorded. DNA was extracted from whole blood with a GeneJET Genomic DNA Purification Kit. An amplification-refractory mutation system polymerase chain reaction approach was used for genotyping of the GPR30 gene (rs3808350, rs3808351, and rs11544331). The differences in genotype and allele frequencies between the leiomyoma and control groups were calculated using the chi-square (χ2) and Fischer’s exact test. The median FSH level was higher in controls (63 vs. 10 IU/L, p=0.000), whereas the median E2 level was higher in the leiomyoma group (84 vs. 9.1 pg/mL, p=0.000). The G allele of rs3808351 and the GG genotype of both the rs3808350 and rs3808351 polymorphisms and the GGC haplotype increased the risk of developing leiomyoma. There was no significant difference in genotype frequencies or leiomyoma volume. However, the GG genotype of the GPR30 rs3808351 polymorphism and G allele of the GPR30 rs3808351 polymorphism were associated with the risk of having a single leiomyoma. Our results suggest that the presence of the GG genotype of the GPR30 rs3808351 polymorphism and the G allele of the GPR30 rs3808351 polymorphism affect the characteristics and development of leiomyomas in the Turkish population.

Pediatricians' COVID-19 experiences and views on the willingness to receive COVID-19 vaccines: a cross-sectional survey in Turkey

Developing an effective and safe vaccine against Covid-19 will facilitate return to normal. Due to hesitation toward the vaccine, it is crucial to explore the acceptability of the COVID-19 vaccine to the public and healthcare workers. In this cross-sectional survey, we invited 2251 pediatricians and 506 (22%) of them responded survey and 424 (84%) gave either nasopharyngeal swap or antibody assay for COVID-19 and 71 (14%) of them got diagnosis of COVID-19. If the effective and safe COVID-19 vaccine was launched on market, 420 (83%) of pediatrician accepted to get vaccine shot, 422 (83%) of them recommended vaccination to their family members, 380 (75%) of them accepted to vaccine their children and 445 (85%) of them offered vaccination to their pediatric patients. Among the participated pediatricians 304 (60%) of them thought COVID-19 vaccine should be mandatory. We found that there are high COVID-19 vaccine willingness rates for pediatricians for themselves, their own children, family members and their pediatric patients. We also found that being a pediatric subspecialist, believing in achieving an effective vaccine, willingness to participate in the phase 1-2 clinical vaccine trial, willingness to get an influenza shot this season, believing a vaccine and vaccine passport should be mandatory were significant factors in accepting the vaccine. It is important to share all information about COVID-19 vaccines, especially effectiveness and safety, with the public in a clear communication and transparency. The opposite will contribute to vaccine hesitancy and anti-vaccine movement.WOS:0006413477000012-s2.0-85115384901PubMed: 3386116