Caregiver Burden and Depression in Parents of Children with Chronic Diseases.

OBJECTIVE: Caregiver burden is a factor that caregivers undertake for patients with chronic diseases and individuals in need of care. Depending on the symptoms of the disease and the processes following the diagnosis, depression problems may develop in caregivers. In this study, it was aimed at determining the caregiving burden of parents who have children with chronic diseases, the condition of special needs, and the factors that affect this burden. MATERIALS AND METHODS: This study is a descriptive cross-sectional study conducted with 206 parents of children who had been diagnosed with a chronic disease for at least 1 year. The sociodemographic data, the Patient Health Questionnaire 2 and 9, and the Burden Scale for Family Caregivers were provided to the parents. RESULTS: Eighty-four of the participants had little or no caregiver burden, while 122 had moderate and severe caregiver burden. The mean caregiving burden score of mothers was higher (P = .004). Fathers' caregiver burden scores varied depending on the level of education (P = .031). Caregiving burden score was found to differ according to income level (P < .001). The mean caregiving burden score of individuals with chronic disease in the family was higher (P < .001). It was determined that individuals with higher Patient Health Questionnaire 2 and 9 scores and those who did not receive psychological support were higher (P < .001). CONCLUSION: Parents who are providing care for children with chronic diseases should be supported and closely monitored for signs of depression. Cite this article as: Güven Baysal S, Çorabay S. Caregiver burden and depression conditions in parents of children with chronic diseases. Turk Arch Pediatr. 2024;59(1):70-77.

Anti-TNF treatment in ankylosing spondylitis patients with chronic kidney disease: Is it effective and safe?

OBJECTIVE: This study aims to examine the efficacy and safety of the antitumor necrosis factor (TNF) drugs in ankylosing spondylitis (AS) patients with chronic kidney disease. METHODS: In this study, 24 male patients with a glomerular filtration rate (GFR) of <60 mL min􏰁1 1.73 m􏰁2 were included among 863 patients who were followed-up once in 3 months regularly from 2010 to 2018years. Twenty-four patients were chosen for the control group among 420 male patients whose renal functions were normal using random sampling. We examined C-reactive protein, erythro- cyte sedimentation rate, serum creatinine, and GFR values, and also the measurements of Bath Anky- losing Spondylitis Disease Activity Index (BASDAI) were recorded at the beginning of the treatment with anti-TNF agents and in the 3rd, 6th, 9th, 12th, and final visit months. RESULTS: Eleven (45.9%) of the patients included in the study were in the routine dialysis program. The initial anti-TNF treatments were etanercept (62.5%), infliximab (16.7%), adalimumab (16.7%), and goli- mumab (4.1%). Treatment was effective in 22 (91.7%) of the patients. When the values of the two groups' patients were compared at the beginning of the treatment, there was a substantial reduction regarding BASDAI (P < .001). Pleural effusion, infective endocarditis, septic arthritis, and prosthesis infection were major side effects (n 1/4 4). The mortality rate of the 24 patients was 29.2% (n 1/4 7). CONCLUSION: This study demonstrated that anti-TNF drug treatment is effective and safe in patients with AS who have chronic kidney disease.

The association between hematologic parameters and intracranial injuries in pediatric patients with traumatic brain injury.

OBJECTIVE: Analyzing the association between hematologic parameters and abnormal cranial computerized tomography (CT) findings after head trauma. MATERIAL AND METHODS: A total of 287 children with isolated traumatic brain injury (TBI) were divided into the 'normal' (NG), 'linear fracture' (LFG) and 'intraparenchymal injury' groups (IPG) based on head CT findings. Demographical/clinical data and laboratory results were obtained from medical records. RESULTS: The neutrophil-lymphocyte ratio was markedly higher in the LFG (p = 0.010 and p = 0.016, respectively) and IPG (p = 0.004 and p < 0.001, respectively) compared with NG. Lower lymphocyte-monocyte ratio (p = 0.044) and higher red cell distribution width-platelet ratio (RPR) (p = 0.030) were associated with intraparenchymal injuries. Patients requiring neurosurgical intervention had higher neutrophil-lymphocyte ratio (p = 0.026) and RPR values (p = 0.031) and lower platelet counts (p = 0.035). Lower levels of erythrocytes (p = 0.005), hemoglobin (p = 0.003) and hematocrit (p = 0.002) were associated with severe TBI and unfavorable outcome (p = 0.012, p = 0.004 and p = 0.006, respectively). CONCLUSIONS: Hematologic parameters are useful in predicting the presence of abnormal cranial CT findings in children with TBI in association with injury severity; surgery need and clinical outcome.

Long-term efficacy and safety of WovenEndoBridge (WEB)-assisted cerebral aneurysm embolization.

PURPOSE: Long-term compaction, compression, migration, and recurrence rates of the WovenEndoBridge devices remain unknown. The purpose of this study was to detect these rates and safety profiles of the WovenEndoBridge within 7 years period. MATERIALS AND METHODS: Eighty-three aneurysms of 79 patients treated with the WovenEndoBridge device were retrospectively evaluated using an occlusion scale (e.g. complete occlusion, neck remnant, and aneurysm remnant) on angiography images. RESULTS: The residual aneurysm was observed in 11 (13%) aneurysms. The mean and median diameters of the recurrent aneurysms were 6 and 7 mm. Most of the recurrent aneurysms were complex type and/or ruptured. Mean diameters and the neck-to-body ratios of all residual aneurysms in the preoperative imaging exams were above 4 mm and 0.6, respectively. The median values of preoperative height and neck measurements were higher in the recurrent aneurysms than in the adequate occlusion group (p = 0.006, p = 0.019, respectively). There was a statistically significant positive relationship between preoperative height/neck measurements and the mean diameters of residual aneurysms (rs = 0.32 and p = 0.003; rs = 0.28 and p = 0.011, respectively). The WovenEndoBridge compaction/compression and migration were observed in 5 (45%) and 2 (18%) of the recurrent aneurysms. In 7 (64%) of the residual aneurysms, thrombosed areas were found within the aneurysm. In the follow-up period, four aneurysms (4.8%) were retreated due to widened residual aneurysm. Other aneurysms were improved or stable within 7 years. DISCUSSION: Our adequate occlusion rate was 87%. Occlusion rates are less favorable than aneurysms with a long height, wide neck, or high neck-to-body ratio. Our study confirms the high safety and efficiency of the WovenEndoBridge. Compaction, compression, and/or migration of the WovenEndoBridge and the presence of intra-aneurysmal thrombosis are the main reasons for the recurrences.