2021 Cilt 19 Sayı 3

Permanent URI for this collectionhttps://hdl.handle.net/11452/27894

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    Çocukluk çağı hipertansiyon kılavuzlarının karşılaştırılması
    (Galenos Yayıncılık, 2021-10-29) Başaran, Cemaliye; Demir, Belde Kasap
    Hipertansiyon (HT) çocukluk çağlarında giderek artan sıklıkta görülmektedir. Bu hastaların daha iyi değerlendirilmesi için çeşitli kılavuzlar yayınlanmıştır. Bunlar içinde en sık kullanılanlar; ABD Ulusal Kalp, Akciğer ve Kan Enstitüsü (NHLBI)’nün Ulusal Yüksek Kan Basıncı Eğitim Programı (NHBPEP) tarafından güncellenerek hazırlanan ve 2004’te yayınlanan 4. Rapor (4. Rapor-2004), 2016 yılında Avrupa Hipertansiyon Derneği tarafından hazırlanan kılavuz (ESH-2016), ve en sonuncusu 2017’de Amerikan Pediatri Akademisi tarafından hazırlanan kılavuzdur (AAP-2017). Bu kılavuzlar benzer olsa da aralarında ciddi farklar bulunmaktadır. 4. Rapor-2004 ve ESH-2016 kılavuzları, daha önce Amerikalı çocuklarda saptanan, yaşa ve boya göre oluşturulan kan basıncı (KB) persentil tablolarını kullanır. Daha sonra obez çocukların ölçümleri çıkarılarak yeni tablolar oluşturulmuş ve AAP-2017’de bu tablolar kullanılmıştır. ESH-2016’da 16 yaş, AAP-2017’de ise 13 yaşından itibaren KB değerlendirmelerinin erişkin kılavuzlarına göre yapılması önerilir. Hipertansif hastanın değerlendirilmesi, Yaşam İçi Kan Basıncı İzlemi (YİKBİ) kriterleri, laboratuvar testlerinin zamanlaması ve tedavi kılavuzlara göre farklılık göstermektedir. Sonuç olarak; henüz tüm dünya çocuklarını kapsayan evrensel KB tabloları oluşturulamamış olduğundan, ofis KB ve YİKBİ’nin değerlendirilmesinde hangi kılavuza göre hareket edileceği noktasında yaş, etnik ve coğrafi koşulların göz önünde bulundurulması gerekmektedir. Güncel olarak yayınlanan kılavuzların takip edilmesi ile ileride gelişebilecek kardiyovasküler olayların azaltılması mümkün olabilecektir.
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    Demographic and laboratory findings of symptomatic and asymptomatic COVID-19 in children
    (Galenos Yayıncılık, 2021-10-21) Çelik, Binnaz; Doğan, Murat; İnan, Doğan Bahadır; Sunkak, Süleyman; Saatçi, Esma; Tubaş, Filiz
    Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a newly described pathogen that is usually transmitted by droplets between person to person. Although the clinical spectrum of COVID-19 ranges from asymptomatic disease to the development of severe acute respiratory distress, children are generally milder than adults. It was aimed to compare the clinical and laboratory values of symptomatic and asymptomatic children followed up with a diagnosis of COVID-19 in this study. Materials and Methods: The records of children with nasopharyngeal swab SARS-CoV-2 Reverse Transcriptase-Polymerase Chain Reaction test positive were analyzed retrospectively. Children with symptoms such as fever, cough, shortness of breath, diarrhea and/or vomiting were accepted as symptomatic, and children with positive SARS-CoV-2 PCR in a nasopharyngeal swab taken only due to contact history and have no symptoms were considered asymptomatic. Results: A total of 197 patients, 47 (23.8%) symptomatic and 150 (76.2%) asymptomatic, were included in the study. The mean age of the children was 9.1±5.2 years (range, 1 month-17 years). Cough (8.6%) was the most common symptom at admission. When the symptomatic and asymptomatic children were compared in terms of white blood cell (WBC), WBC subgroups, C-reactive protein there was no statistically significant difference. No significant increase was found in the CRP values of symptomatic patients. Ground-glass opacities compatible with COVID-19 was detected in only 10 (30%) of 33 symptomatic patients who underwent thoracic tomography. Conclusion: COVID-19 is usually mild in children. At the same time, a significant change in laboratory parameters and imaging findings may not be observed in symptomatic and/or asymptomatic children with positive SARS-CoV-2 PCR.
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    The effect of obesogenic environment and socio- demographic characteristics on obesity awareness levels of children
    (Galenos Yayıncılık, 2021-08-31) Sarıalioğlu, Arzu; Küçükoğlu, Sibel; Özdemir, Aynur Aytekin; Köse, Semra; Çelebioğlu, Ayda
    Introduction: The purpose of the study is to determine the effect of obesogenic environment and sociodemographic characteristics on children’s obesity awareness levels. Materials and Methods: The sample of the study was composed of a total of 540 children studying at the 5 th grade (63), 6 th grade (73), and 7 th grade (79) in the private school and at the 5th grade (131), 6th grade (108), and 7th grade (86) in the public school specified between the dates when the study was conducted. “Descriptive Information Form”, “Obesogenic Environmental Evaluation Form (OEEF)” and “Obesity Awareness Scale (OAS)” were used to collect the data. Results: It was determined that OEEF mean score was higher in children studying in the public school (10.50±2.23) than those studying in the private school (7.77±2.36) and the difference between them was significant. OAS “physical activity” subscale mean score was significantly higher in children studying in the public school. Conclusion: When OEEF and OAS mean scores were examined according to sociodemographic variables, it was found that there was a significant difference between the groups in terms of some variables. It was determined in the study that the children studying in the public school were affected more by the obesogenic environmental conditions and gender increased the obesity awareness level of the children. Within the scope of the fight against obesity, it is recommended to conduct consciousness-raising and awareness programs related to obesogenic environment in all educational institutions primarily in public schools.
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    Retrospective evaluation of cases with cow’s milk allergy
    (Galenos Yayıncılık, 2021-11-10) Efe, Hülya Poyraz; Canıtez, Yakup; Sapan, Nihat; Tıp Fakültesi; Çocuk Alerjisi Ana Bilim Dalı; 0000-0002-2226-7035; 0000-0001-8929-679X; 0000-0002-7601-8392
    Introduction: Cow’s milk allergy (CMA) is described as immunological reaction against to one or more milk proteins. It is known that CMA which affects about 1-3% of the general population is the most commonly seen food allergy in infants and children. It is well known that a tolerance develops and prognosis is better during the first three years of the life. In the present study, we aimed to investigate the natural course of cases diagnosed with CMA and to determine the factors which have impact on the tolerance development. Materials and Methods: Medical records of cases who have been followed for CMA were retrospectively reviewed. Gender, age at first symptom, breastfeeding duration, family atopy history, multiple food allergies, concomitant allergic diseases, inhalant allergy sensitivity and clinical manifestation of cases were assessed. Also, prick test results, milk-specific IgE, casein-specific IgE and the reactions that developed during food challenge test were evaluated. Results: The age at first symptom was mean 4±2,3 months. Twenty-two percent of patients had a positive family history of atopy and 30% had multiple food allergies. There were concomitant allergic disorders in 58% of patients. Skin (93.8%), gastrointestinal system (GIS) (24.7%) and respiratory system (18.5%) symptoms were most commonly seen. The percentage of tolerance development by the years was determined as 41% for the first year, 64% for the second year and 75% for the third year. Milk-specific IgE level at the time of diagnosis (p=0.010) and asthma presence (p=0.010) were found significant risk factors for persistent CMA. Conclusion: Clinical parameters and allergy tests may help to predict the prognosis of CMA. Milk-specific IgE level at the time of diagnosis is the risk factor for persistent CMA.