Highlights SARS-CoV2 pandemic affects daily life of people, negatively. Children with MS seem to be more affected in terms of anxiety symptoms due to their susceptibility to anxiety. Establishment of separate health centers to be used during such pandemic/ epidemic periods for patients with chronic diseases such as MS may be recommended.
Background Respiratory involvement is the main factor predicting the prognosis of spinal muscular atrophy (SMA). Significant responses in motor functions have been demonstrated with nusinersen, but pulmonary outcomes are still varied. We aimed to explore the effects of nusinersen on the respiratory functions of patients with SMA. Methods Patients with SMA who were receiving regular nusinersen treatment in our tertiary care hospital were enrolled in this study. We evaluated the patients in terms of the necessity to ventilatory or nutritional support, presence of motor involvement and other comorbidities related with prognosis at three consecutive assessments. Results The study group consisted of 43 patients (18 type 1, 12 type 2, and 13 type 3) with SMA with a mean age of 27.8 months at diagnosis and 60.8 months at the beginning of nusinersen treatment. The respiratory function improvements were noted in six patients at third assessment. Early initiation of nusinersen was significantly correlated with reduced hospital admissions (P = 0.026). Nutritional support and weight gain were remarkable in the ventilatory‐supported group. Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores were significantly higher in the non‐tracheostomized group in patients with SMA type 1 (P < 0.005). Conclusions We posit that nusinersen may change the natural prognosis of SMA and improve care of children with SMA. Following up children with SMA for longer periods under nusinersen may be beneficial for understanding the effects of treatment. Results of our study need to be supported by future long‐term studies to reach a consensus on nusinersen, considering the overall genetic and environmental status as well as the cost‐effectiveness of the treatment.
Childhood obesity is one of the most important children's health problems that is gradually increasing all over the world. Dyslipidemia which coexists with obesity is a risk factor for atherosclerotic diseases in adulthood. In this study, the usability of the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in predicting dyslipidemia, a serious complication of obesity, in children were investigated. Method: Two hundred and seven cases aged between 11-17 years who were diagnosed with obesity at the Pediatrics Clinic of our hospital and 50 cases with no disorders whose complete blood count was performed for routine purposes were retrospectively investigated. The genders, ages, and examination findings of the cases were recorded. In obese children, leukocyte, hemoglobin, platelet, mean platelet volume, neutrophil and lymphocyte levels were evaluated in the complete blood count performed at the first admission. The NLR and the PLR were calculated. Preprandial blood glucose and preprandial insulin, serum aminotransferase values, and the lipid profile were recorded. Results: While dyslipidemia was determined in 99 (47.82%) of 207 cases who were diagnosed with obesity, it was not determined in 108 (52.18%) cases. The systolic blood pressure, diastolic blood pressure, and preprandial insulin level were higher in cases with dyslipidemia than the group without dyslipidemia. The PLR average of the dyslipidemic group was 112.75±39.11, the PLR average of the non-dyslipidemic group was 104.78±31.38, and the PLR average of the control group was 110.20±39.35, and there was no statistically significant difference between the PLR averages of the groups (p=0.353). The NLR average was 1.52±0.69 in Amaç: Çocukluk çağı obezitesi tüm dünyada giderek artan en önemli çocuk sağlığı sorunlarından biridir. Obezite ile birlikte olan dislipidemi, erişkin dönemde aterosklerotik hastalıklar için bir risk faktörüdür. Bu çalışmada çocuklarda, obezitenin ciddi bir komplikasyonu olan dislipidemiyi öngörmede nötrofil-lenfosit oranı (NLO) ve platelet-lenfosit oranının (PLO) kullanılabilirliğini araştırdık. Yöntem: Hastanemiz Çocuk Sağlığı ve Hastalıkları Kliniği'nde obezite tanısı alan 11-17 yaş arası 207 olgu ve herhangi bir rahatsızlığı olmayıp rutin amaçlı tam kan tahlili yapılan 50 olgu retrospektif olarak incelendi. Olguların cinsiyetleri, yaşları, muayene bulguları kaydedildi. Obez çocuklarda ilk başvuruda alınan tam kan sayımında lökosit, hemoglobin, trombosit, ortalama trombosit hacmi, nötrofil ve lenfosit düzeyleri değerlendirildi. NLO ve PLO hesaplandı. Açlık kan şekeri ve açlık insülin, serum aminotransferaz değerleri ve lipid profili kaydedildi. Bulgular: Obezite tanısı alan 207 olgunun 99'unda (%47,82) dislipidemi saptanırken, 108 olguda (%52, 18) dislipidemi saptanmadı. Dislipidemi saptanan olguların sistolik kan basıncı, diastolik kan basıncı ve açlık insülin düzeyi dislipidemi olmayan gruptan daha yüksekti. Dislipidemik grubun PLO ortalaması 112,75±39, 11, dispidemik olmayan grubun PLO ortalaması 104,78±31,38,...
Objectives: This study aimed to monitor the health and nutritional status of pediatric cystic fibrosis (CF) patients via telehealth services during the novel coronavirus disease 2019 . Additional aims were to determine the level of anxiety in the patients and their caregivers and to determine the COVID-19 transmission status among CF patients. Materials and Methods: The CF team supported the patients via remote contact. During telehealth services interviews, in addition to obtaining information about the patients' anthropometric measurements, health status, and CF-related complaints, the State-Trait Anxiety Inventory (STAI) was administered to the patients and controls. The Hospital Anxiety and Depression Scale (HAD) was administered to their caregivers. Results: The study included 144 pediatric CF patients (74 males and 70 females). Mean age of the patients was 8.9 years. In all, 42 (29.2%) of the patients were tested for COVID-19, of which 4 were positive. The mean STAI score was significantly lower in the patient group than in the control group (p < 0.001). The mean HAD anxiety score was significantly higher in the caregivers of the CF patients, compared to the caregivers of the controls (p = 0.005). In addition, the mean HAD depression score was significantly higher in the caregivers of the CF patients (p < 0.001). Conclusions: Telehealth is an innovative method for providing health care services while maintaining social distance and avoiding the risk of exposure and spread of COVID-19. Telehealth services reduce patient and parental anxiety and increase the level of confidence in managing CF-related complications.
Acute viral respiratory tract infection is the leading cause of hospitalization for infants and young children in developed countries and is a major cause of death in developing countries. The aim of this study was to identify the viruses in children hospitalized for lower respiratory tract infections (LRTI) during the winter period and to evaluate the relationship between the clinical features of these patients and the severity of their disease. Materials and Methods: The nasopharyngeal aspirates of 200 patients aged 0-24 months hospitalized with a diagnosis of LRTI were analyzed using the real-time polymerase chain reaction method. We looked for associations between the viral agent, duration of hospitalization and respiratory distress scale. Results: The viral factor was identified in 150 (75%) patients. Rhinovirus was the most frequent viral agent followed by respiratory syncytial virus and adenovirus; (52.67%), (16.0%) and (8.67%) respectively. The average length of hospitalization for respiratory syncytial virus (p=0.001), adenovirus (p=0.009), influenza A virus (p=0.007), and bocavirus (p=0.009) infections were significantly longer. Adenovirus (p=0.029), respiratory syncytial virus (p=0.001) and bocavirus (p=0.009) were significantly associated with length of hospitalization. No significant correlation was identified between the viruses and respiratory distress scores (p>0.05). Conclusion: We conclude that in hospitalized children with LRTIs, rhinovirus was the most frequently observed viral etiological agent. A longer period of hospitalization was needed for respiratory syncytial virus, adenovirus and bocavirus in infants with LRTIs. Infants with respiratory infections should be monitored due to the risk of developing severe complications during disease progression.
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