ABSTRACT
Objective: In this case series, we aimed to examine the changes in lymphocyte subgroups in children diagnosed with the multisystem inflammatory syndrome (MIS-C) during the acute phase and in the first month after treatment. Material and Methods: Ethics committee approval was received for the study from the Ethics Committee of Ondokuz Mayis University patient data were analyzed from medical records in an electronic database. Initial immunological evaluations of our first five patients diagnosed with MIS-C were made, steroid and IVIG treatments were given to the patients, and lymphocyte subgroups were evaluated for the second time in the first month for control purposes. Results: In MIS-C cases, it was observed that lymphopenia was severe in the acute period, CD3 T cells decreased, the ratio of 2:1 between cytotoxic T cells and helper T cells was impaired, B cells increased proportionally, and NK cells were normal or decreased. When we evaluated MIS-C cases with the control lymphocyte subgroup in the first month, it was observed that lymphopenia improved and CD3 T cells increased proportionally, and active T cells decreased to normal values in the first month after treatment. On the other hand, while naive B cells decreased, non-switching and switching B cells increased and NK cells decreased. Conclusion: While COVID-19 is an acute infection, MIS-C is associated with cytokine storm induced by the acute infection. Immunologic assessment of MIS-C cases is considered important since the condition causes immune dysregulation in the host immune system. Lymphopenia, increased B cell count, reversal of the CD4/CD8 ratio, and increased active T cell count may be beneficial in the early diagnosis of MIS-C. Since it is thought that the cytokine storm causes complications in MIS-C, immediate administration of IVIG treatment is considered essential. Although it was demonstrated that the disease manifests with marked cellular changes, there is still a need for further studies.
ABSTRACT
Aim: This study aims to determine the effects of play activities for COVID-19 positive and MIS-C pediatric patients on the anxiety and fear of children and their parents. Method(s): This is an experimental study that was prepared through STROBE. The study population consisted of 38 children treated in a university hospital COVID-19 unit. The Children's Anxiety Meter-State and the Children's Fear Scale were administered before and after the play activities. The parents' fear and anxiety were assessed using the COVID-19 Phobia Scale and the Beck Anxiety Inventory. The book and coloring set was prepared in advance and delivered to the experimental group in a package. After the sets were given to the parents, the parents read the book to their children the same day. Afterward, they were asked to color pictures of coronavirus precautions together with the children. SPSS 22.00 package program was used to analyze the study data. The Mann-Whitney U test was used to compare independent groups, and Wilcoxon analysis was used to analyze dependent variables before and after the play activities. Result(s): Based on the children's anxiety and fear scores in the experimental group, significant differences were found before and after the play activities and significant differences between the anxiety scores (<0.05) of parents and children. However, no significant difference was found between post-play anxiety and fear scores of children in the experimental group and the scores of the control group. Discussion(s): The experimental group had low mean anxiety and fear scores after the play activities. Play activities should be used to reduce the anxiety and fear of children who are treated in isolation in hospitals during the COVID-19 pandemic. Even if children are restricted to isolation rooms, their daily routines should be maintained, and their parents should be supported.Copyright © 2021 Croatian Paediatric Society. All rights reserved.
ABSTRACT
Objective: In this case series, we aimed to examine the changes in lymphocyte subgroups in children diagnosed with the multisystem inflammatory syndrome (MIS-C) during the acute phase and in the first month after treatment. Material and Methods: Ethics committee approval was received for the study from the Ethics Committee of Ondokuz Mayis University patient data were analyzed from medical records in an electronic database. Initial immunological evaluations of our first five patients diagnosed with MIS-C were made, steroid and IVIG treatments were given to the patients, and lymphocyte subgroups were evaluated for the second time in the first month for control purposes.
ABSTRACT
To determine the healthcare satisfaction of the parents staying in the hospital with their children diagnosed Covid-19 towards family-centered care and to determine the relationship between them. This was a descriptive, correlational and cross-sectional type study. Data were collected in a pediatric outpatient clinic of a university hospital between March-June 2021. The universe of the study consisted of 141 parents, and the calculated sample size was 59. The study was completed with 64 parents. Data of the study were collected in the light of literature by using Sociodemographic Information Form, The Family-Centered Care Scale and The Pediatric Quality of Life Healthcare Satisfaction Inventory. Data were analyzed by SPSS 21 statistical package program. The ethics approval was taken from the clinical research ethics committee of the relevant university. The mean score of the parents from the Family-Centered Care Scale was 60.58+/-8.77, the mean PedsQL Healthcare Satisfaction Inventory score of the parents was found to be 71.75+/-24.21. A positive and moderate level of correlation was found between the Family-Centered Care Scale and PedsQL Healthcare Satisfaction Inventory and their subscales. It was found that nurses helped families and children to feel well cared for;however, they did not get the opinions of the family at a sufficient level while planning care. In the study, the healthcare satisfaction of the parents was at an adequate level. Besides, it was determined that the opinions of parents regarding family-centered care positively affected their satisfaction. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.
ABSTRACT
Objective: Multisystem inflammatory syndrome (MIS-C) in children is a newly defined and serious health problem that develops after SARS-CoV-2 infection. Our aim is to report epidemiological, clinical, laboratory and radiological features of children with MIS-C. Material and Methods: Forty patients who applied to our hospital from October 2020 to February 2021 and met the MIS-C criteria were included in the study. Patients with gastrointestinal involvement (GIS), cardiac involvement and Kawasaki Disease (KD)-like MIS-C were examined clini-cally and laboratory. Results: The mean age of the patients was 8.2 ± 4.2 years and male patients were in the majority (70%). The most common symptoms were fe-ver (100%) and fatigue (90%). Gastrointestinal symptoms were present in 71%, cardiac involvement in %40, Kawasaki-like patients in %52.5, shock symptoms in 59%. Elevated levels of C-reactive protein, D-dimer, and ferritin were found in 100%, 97.5%, and 67.5% of the patients, respec-tively. Patients with cardiac involvement had higher mean age and lower lymphocyte levels. Shock findings were higher in patients with KD-like MIS-C. Also, INR and ferritin levels were higher in KD-like MIS-C patients (p= 0.028). The mean platelet count (p= 0.004) and albumin levels were lower (p= 0.048) in shock group. Conclusion: MIS-C is a hyperinflammatory syndrome with cardiac, GIS, and lung involvement. Cardiac findings were not common in patients presenting with KD-like MIS-C, but a poor prognosis was observed in KD-like MIS-C patients. Patients with cardiac involvement were older and their lymphocyte count was lower.
ABSTRACT
Since December 2019, 2019 outbreak of coronavirus (Covid-19) spread all over the world as well as in Turkey. In this study, we aimed to investigate the clinical and laboratory effects of covid 19 disease on children. The epidemiological, laboratory, radiological, and treatment features of the 30 pediatric patients with covid-19 evaluated retrospectively. The median age of the patients was 10 years, boys and girls ratio was 1.5 (18/12). Of the patients, 80.7% had family contact and 11.5% had comorbidity. The most common symptom was fever (84.6%), and cough was the second frequency (57.7%). All patients except 1 patient had a mild course, 5 were asymptomatic. One patient needed intensive care who had underlying chronic disease. Neutropenia was the most common laboratory anomaly (36.6%). Increased D-dimer levels were observed in 9 patients (30%), decreased leukocyte was in 7 patients (23.3%) and increasedlactate dehydrogenaz level was in 8 patients (26.6%). Chest computed tomography was taken 14 patients who had an abnormal chest X-rays, and ground-glass opacities were seen in 6 patients (20%). Hydroxychlorachine, azithromycin and other antibiotic treatments were given to the necessary patients. The mean PCR negative time in the treated symptomatic group was 8.8 +5.34 day, while in the untreated asymptomatic group 12 + 5.19 day and there was no statistically significant difference (p=0.154). The correlation between PCR negative time and clinical, laboratory, and radiological findings was examined and no correlation was found. In conclusion, pediatric covid 19 is mostly transmitted by family contact and has a mild course if there is no underlying disease. The most common symptoms are fever and cough. Ground glass densities on lung tomography are similar to adult. More conservative approaches may be preferred in children.
ABSTRACT
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.
ABSTRACT
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.