Astımlı çocuklarda trombosit aktivasyonunun belirlenmesi

Astım, kronik inflamatuvar bir hastalıktır. Mast hücreleri, eozinofiller, T lenfositler, dendritik hücreler, makrofaj ve nötrofiller inflamasyonda rol oynayan hücrelerdir. Duyarlı kişilerde bu inflamasyon nöbetler şeklinde gelen öksürük, hışıltılı solunum, nefes darlığı ataklarına neden olmaktadır. Literatürde ortalama trombosit hacmi (MPV) ve trombosit dağılım aralığının (PDW) ailevi akdeniz ateşi, romatoid artrit gibi inflamatuvar hastalıkların alevlenme dönemlerinde değerlerinin değiştiği yönündedir. Bu çalışmanın amacı; astımlı çocukların atak anında ve ataktan en az 1 ay sonra semptomsuz dönemde MPV, PDW, plateletcrit (PCT) ve P selektin düzeylerindeki değişimlerin belirlenerek atak sırasında belirteç olarak kullanılabilirliğinin olup olmadığını incelemektir. Başkent Üniversitesi Tıp Fakültesi Ankara Hastanesi Pediatrik Alerji Polikliniği’ ne Nisan 2011- Temmuz 2011 tarihleri arasında başvuran, yaş dağılımı 6 ile 16 arasında olan 40 hasta çalışmaya alındı. Çocukların 22’ si hafif, 18’ i orta-ağır astım atağında idi. Hastalardan atak anında MPV, PDW, PCT, P selektin, eozinofil ve trombosit düzeyi için kan alındı. Solunum fonksiyon testleri spirometre cihazı ile yapıldı. Hastalara atak tedavisi olarak inhale steroid, inhale kısa etkili β2-agonist ve oral steroid tedavisi verildi. Hastalar ataktan en az 1 ay sonra semptomsuz oldukları dönemde tekrar görüldü. Hastalardan MPV, PDW, PCT, P selektin, eozinofil ve trombosit düzeyleri için tekrar kan alındı, solunum fonksiyon testleri tekrarlandı. Hastaların atak anında ve ataktan en az 1 ay sonra bakılan trombosit sayısı ve PDW değerlerinde anlamlı fark yok iken, MPV, PCT ve P selektin düzeyleri atak anında anlamlı düşük saptandı. Hafif ve orta-ağır astım atağı grupları atak anında ayrı ayrı değerlendirildiklerinde MPV ve PCT düzeylerinin atak sonrasına göre anlamlı düşüklük olduğu görülmüşken, trombosit sayısı, iii PDW ve P selektin düzeylerindeki fark anlamlı bulunmadı. Hafif ve orta-ağır astım atağı grupları birbirleriyle karşılaştırıldığında atak anında trombosit aktivasyon belirteçleri arasında istatistiksel fark görülmedi. Beyaz küre ve parçalı sayısının atak anında atak sonrasına göre anlamlı yüksek olduğu görüldü. Sonuç olarak; rutin pratikte sık kullanılan tam kan sayımı parametrelerinin içinde olan MPV, PDW, PCT’ nin atak tayini ve şiddetini belirlemede kullanılabileceğini düşünmekteyiz. Çalışmamızda hasta sayısının kısıtlılığı en önemli sorundu ancak ileride yapılacak daha kapsamlı çalışmaların, trombosit aktivasyon belirteçlerinin astım atağındaki klinik önemini daha net bir şekilde ortaya koyabileceğini düşünmekteyiz

Preseptal and Orbital Cellulitis in Childhood: The Experience of Ankara Training and Research Hospital

Aim:Evaluation of the etiology, clinical and laboratory findings, treatment and complications of preseptal and orbital cellulitis in patients and to show that these complications can be prevented with early diagnosis and effective treatment.Materials and Methods:Thirty-eight patients with orbital and preseptal cellulitis who had been admitted to Ankara Training and Research Hospital, Clinic of Paediatric between September 2015 and February 2017 were retrospectively studied.Results:Thirty-five patients (92.1%) were diagnosed with preseptal cellulitis and 3 patients (7.9%) were diagnosed with orbital cellulitis. The mean age at diagnosis of the patients [24 girls (63.2%) and 14 boys (36.8%)] was 4.01±3.72 years. The most frequent etiologic factor was conjunctivitis (28.9%). Twenty-five patients (65.7%) were treated with intravenous ampicillin-sulbactam alone as the first treatment. No patient underwent surgery. All patients recovered completely without any eye illnesses and no complications were observed.Conclusion:Orbital infections can be healed through early diagnosis and effective antibiotic therapy in childhood and ampicillin-sulbactam therapy alone should be preferred over combination therapy due to its high effectiveness and relatively low side effects

The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media

Background: Acute otitis media (AOM) is one of the most common childhood infections. Ear pain, the main symptom of AOM, results in parents frequently seeking medical assistance for their children. The aim of this study was to compare the effectiveness of topical 1% lidocaine ear drops administered with oral analgesics with that of oral analgesics alone. Methods: This multicenter randomized, open-labeled study was conducted at 15 centers with 184 pediatric AOM patients with bilateral ear pain (aged 1–5 years) between May 1, 2016, and June 31, 2018. All patients received oral paracetamol or ibuprofen and topical 1% lidocaine, which was administered to each ear according to the randomization list. The ear pain score was evaluated within 48 h using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, and the patients were followed up for 10 days. Results: The median age was 31.8 months (min–max, 12–84.2 months). Of those patients enrolled, 22.3% received paracetamol, and 24.5% received paracetamol with lidocaine ear drops; 23.4% received ibuprofen, and 29.9% received ibuprofen with lidocaine ear drops. Lower pain scores were significantly measured at baseline and 10th minutes by a reduction 25% (RR 13.64, 95% CI 4.47–41.63, p = 0.001, RR 0.14, 95% CI 0.06–0.35, p = 0.001) and 50% (RR 4.76, 95% CI 1.63–13.87, p = 0.004, RR 0.14, 95% CI 0.05–0.4, p = 0.001) in the paracetamol and lidocaine versus paracetamol groups and the ibuprofen and lidocaine versus ibuprofen groups, respectively. No serious side effects were evident during follow-up. Conclusion: This randomized study suggests that topical 1% lidocaine ear drops with paracetamol or ibuprofen seems to provide effective and rapid relief for children presenting with ear pain attributed to AOM

Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy

Background: Antibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region. Methods: The prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre. Results: A result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect. Conclusion: This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region

Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control Covid-19 pandemisinde enfeksiyon kontrol çalışmaları çerçevesinde çocuk hastalarla çalışan sağlık personeli eğitimi

© 2020, AVES. All rights reserved.Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic

SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: A nationwide surveillance.

BACKGROUND: COVID-19 pandemic affected every single person on earth one way or the other. The healthcare personnel were no exception, their responsibilities as well as their risks being immense. METHODS: 4927 healthcare personnel all working in pediatric units at 32 hospitals from seven different regions of Turkey enrolled to the study to determine the seroprevalence of SARS Co-V-2 after the first peak wave. Point of care serologic lateral flow rapid test kit for IgM/IgG was used (Ecotest CE Assure Tech. Co. Ltd.). Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. RESULTS: Nearly 6.1% of healthcare personnel were found to be seropositive for SARS Co-V- 2. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19 co-worker increased the likelihood of infection. The least and the most experienced personnel affected more. Most of the seropositive healthcare personnel (68%) did not have any suspicion that they had COVID-19 previously. CONCLUSIONS: Health surveillance for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission