The relationship between the use of digital display devices and headphones and primary headaches in children.

BACKGROUND: Headache represents the most common neurologic symptom in children. In this study, we investigated the relationship between watching television, listening to music with headphones, smartphone, tablet, and computer use, and primary headaches in children. We aimed to determine whether primary headache in children is associated with excessive use of digital display devices and headphones and whether reducing the use of digital display devices and headphones affects primary headache. METHODS: The study included 69 children with primary headaches and 64 with no headaches as a control group. All subjects were evaluated for demographic and headache characteristics and the use of digital display devices and headphones. Our recommendation for patients and families was to decrease the use of digital display devices and headphones, and the headache burden was re-evaluated after one month. RESULTS: Headache frequency was more common in patients who watched television and used smartphones or tablets for more than 6 hours per day. Using a smartphone or tablet for more than 3 hours daily was more common in the study group than the control group. Headache frequency decreased in all patients one month after the digital imaging device and headphones were restricted. CONCLUSIONS: Watching television and using a smartphone or tablet strongly associates with primary headaches during childhood.

INTRODUCCIÓN: La cefalea representa el síntoma neurológico más común en los niños. En este estudio se investigó la relación entre ver televisión, escuchar música con auriculares, el uso del teléfono inteligente o tableta y computadora y el dolor de cabeza primario en niños. Nuestro objetivo fue determinar la asociación entre la cefalea primaria en niños y el uso excesivo de dispositivos de visualización digital y auriculares, y el efecto de la disminución del uso de dispositivos de visualización digital y auriculares sobre la cefalea primaria. MÉTODOS: El estudio incluyó a 69 niños con cefaleas primarias y 64 niños sin cefaleas como grupo control. Se evaluaron las características demográficas y de dolor de cabeza y uso de dispositivos de visualización digital y auriculares de los participantes. Se aconsejó a los pacientes y familiares que disminuyeran el uso del dispositivo de pantalla digital y los auriculares y se volvió a evaluar la carga de dolor de cabeza después de 1 mes. RESULTADOS: La frecuencia de la cefalea fue más frecuente en los pacientes que veían televisión y utilizaban un teléfono inteligente o una tableta más de 6 horas al día. El uso de más de 3 horas al día fue más común en el grupo de estudio que en el grupo control. La frecuencia del dolor de cabeza disminuyó en todos los pacientes 1 mes después de la restricción del dispositivo de imagen digital y los auriculares. CONCLUSIONES: Ver la televisión y el uso de un teléfono inteligente o tableta se asocian estrechamente con el dolor de cabeza primario en la infancia.

The relationship between the use of digital display devices and headphones and primary headaches in children / La relación entre el uso de dispositivos de visualización digital y auriculares y el dolor de cabeza primario en niños

Abstract Background: Headache represents the most common neurologic symptom in children. In this study, we investigated the relationship between watching television, listening to music with headphones, smartphone, tablet, and computer use, and primary headaches in children. We aimed to determine whether primary headache in children is associated with excessive use of digital display devices and headphones and whether reducing the use of digital display devices and headphones affects primary headache. Methods: The study included 69 children with primary headaches and 64 with no headaches as a control group. All subjects were evaluated for demographic and headache characteristics and the use of digital display devices and headphones. Our recommendation for patients and families was to decrease the use of digital display devices and headphones, and the headache burden was re-evaluated after one month. Results: Headache frequency was more common in patients who watched television and used smartphones or tablets for more than 6 hours per day. Using a smartphone or tablet for more than 3 hours daily was more common in the study group than the control group. Headache frequency decreased in all patients one month after the digital imaging device and headphones were restricted. Conclusions: Watching television and using a smartphone or tablet strongly associates with primary headaches during childhood.

Resumen Introducción: La cefalea representa el síntoma neurológico más común en los niños. En este estudio se investigó la relación entre ver televisión, escuchar música con auriculares, el uso del teléfono inteligente o tableta y computadora y el dolor de cabeza primario en niños. Nuestro objetivo fue determinar la asociación entre la cefalea primaria en niños y el uso excesivo de dispositivos de visualización digital y auriculares, y el efecto de la disminución del uso de dispositivos de visualización digital y auriculares sobre la cefalea primaria. Métodos: El estudio incluyó a 69 niños con cefaleas primarias y 64 niños sin cefaleas como grupo control. Se evaluaron las características demográficas y de dolor de cabeza y uso de dispositivos de visualización digital y auriculares de los participantes. Se aconsejó a los pacientes y familiares que disminuyeran el uso del dispositivo de pantalla digital y los auriculares y se volvió a evaluar la carga de dolor de cabeza después de 1 mes. Resultados: La frecuencia de la cefalea fue más frecuente en los pacientes que veían televisión y utilizaban un teléfono inteligente o una tableta más de 6 horas al día. El uso de más de 3 horas al día fue más común en el grupo de estudio que en el grupo control. La frecuencia del dolor de cabeza disminuyó en todos los pacientes 1 mes después de la restricción del dispositivo de imagen digital y los auriculares. Conclusiones: Ver la televisión y el uso de un teléfono inteligente o tableta se asocian estrechamente con el dolor de cabeza primario en la infancia.

Congenital Hemophilia A Presenting With Hashimoto's Encephalopathy and Myocarditis: The First Reported Case.

Here, we report a case of hemophilia A with myocarditis, encephalopathy, and spontaneous intramedullary hemorrhage. A 14-month-old male infant presented with loss of consciousness, generalized tonic-clonic convulsions, and cardiac failure. The neurological examination was normal. Myocarditis was diagnosed. After administration of fresh frozen plasma, the aPTT did not return to normal. The factor VIII (FVIII) level was 10.2% the normal level, and the patient was diagnosed with hemophilia A. The cerebrospinal fluid (CSF) evaluation was unremarkable, with the exception of elevated CSF protein levels. An electroencephalogram revealed diffuse slowing of background activity. The spinal MRI revealed chronic bleeding in areas of the medulla spinalis. Tests for the antibodies associated with autoimmune encephalitis were negative. Anti-thyroglobulin (THG) (11.8 U/mL [normal, 0 to 4 U/mL]) and anti-thyroid peroxidase (TPO) (53.9 U/mL [normal, 0 to 9 U/mL]) antibodies were present in the serum. The patient received 1 g/kg intravenous immunoglobulin G (IVIG) for 2 days based on a diagnosis of myocarditis and Hashimoto's encephalopathy. After the first month of treatment his clinical findings were negative. He developed an inhibitor to FVIII 1 month after initiation of FVIII replacement therapy. Hemophilia A has various clinical presentations. Autoimmunity may lead to early inhibitor development in patients with hemophilia.

Important of Angiopoietic System in Evaluation of Endothelial Damage in Children with Crimean-Congo Hemorrhagic Fever.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) causes endothelial activation and dysfunction by affecting the endothelium directly or indirectly. In maintaining the vascular integrity, vascular endothelial growth factor (VEGF-A) and its receptor (VEGFR1) and angiopoietin-2 (Ang-2) and its receptor (Tie-2) are very important mediators. For this reason, we aimed at studying the association of Ang-2 and VEGF and their receptors Tie-2 and VEGFR1 with CCHF infection. METHODS: Thirty one CCHF patients and 31 healthy controls (HC) were included in the study. CCHF patients were classified into 2 groups in terms of disease severity (severe and nonsevere). VEGF-A, VEGFR1, Ang-2 and Tie-2 levels were measured in all groups. RESULT: Serum levels of Tie-2, Ang-2, VEGF-A and VEGFR1 were significantly increased in CCHF patients compared with the HC. Furthermore, serum Tie-2, Ang-2, VEGF and VEGFR1 levels were found to be significantly higher in the severe group than in the nonsevere and HC groups (P < 0.05 and P < 0.001, respectively). Also, Tie-2, Ang-2, VEGF-A and VEGFR1 levels were significantly higher in the nonsevere group than in the HC group (P < 0.05). CONCLUSION: Having statistically significant higher Ang-2, Tie-2, VEGF-A and VEGFR1 levels in the severe group when compared with the other groups suggested that VEGF-related Ang-2/Tie-2 system played a critical role in the pathogenesis of the disease, and these markers could be used as the severity criteria.

Evaluation of serum perforin, caspase-3, sFasL and M-30 levels as apoptotic markers in children with Crimean-Congo hemorrhagic fever.

BACKGROUND: Apoptosis is a main regulator in responses of cellular immunity throughout systemic viral infections. Perforin, soluble Fas ligand, caspase-3 and caspase-cleaved cytokeratin-18 (M-30) are mediators of apoptosis. The aim of this study is the evaluation of Crimean-Congo hemorrhagic fever (CCHF) disease changes in the levels of these apoptotic markers and the relation of these changes with disease severity. METHODS: Forty-nine hospitalized children with CCHF and 36 healthy controls were enrolled in this prospective study. The CCHF patients were classified into 2 groups based on disease severity (severe group and nonsevere group). Demographic characteristics and clinical and laboratory findings of all patients were recorded on admission. RESULTS: Serum perforin, caspase-3 and soluble Fas ligand levels were found to be significantly higher both in the severe and nonsevere CCHF groups than the healthy control group (P < 0.05), but there was no significant difference in these apoptotic markers between severe and nonsevere CCHF groups (P > 0.05). In addition, serum M-30 levels did not differ significantly among all groups (P > 0.05). There was a positive correlation between serum values for perforin, caspase-3 and M-30 and the disease's severity criteria such as aspartate aminotransferase and/or alanine aminotransferase. The serum levels of all these markers were negatively correlated with disease severity criteria such as the platelet count. CONCLUSIONS: In this study, we concluded that the interactions of cytolytic granules containing perforin and caspase cascade and Fas-FasL may play an important role in the pathogenesis of CCHF in children.