Benign acute childhood myositis associated with influenza A/B in the paediatric emergency department and the efficacy of early-onset oseltamivir.

AIM: To investigate the association of benign acute childhood myositis (BACM) with respiratory viruses. Also, we aimed to assess the effect of antiviral treatment on the improvement and complications. METHODS: This study was conducted at an urban-academic emergency department during four influenza-seasons (2016-2019), retrospectively. Demographics, clinical findings, laboratories, metabolic disease analyses and serological features were extracted from the medical records. Treatments, complications and outcomes were also recorded. RESULTS: A total of 114 children were included. The median age was 7.0 (min 1.25-max 17) years and 78.9% were male. The most common symptoms were leg pain (91.2%), anorexia (54.4%), fever (45.6%), sore throat (42.1%) and walking difficulty (32.5%). On admission, the median creatine phosphokinase level was 3332 IU/L (range, 1634-50 185), median aspartate aminotransferase 107 U/L (range, 38-1798). In the multiplex polymerase chain reaction analysis, 40.4% influenza B, 36.8% influenza A, 7.8% adenovirus, 7.8% parainfluenza virus, 5.3% rhinovirus, 5.3% respiratory syncytial virus and 1.8% Mycoplasma pneumoniae were detected. Rhabdomyolysis was developed in 6.7% and acute renal failure was seen in two patients. Oseltamivir was given in 44 (38.6%) patients who had influenza A/B. Metabolic disease screening tests were performed in 33.3% of patients and metabolic diseases were detected in 4 (3.5%) patients. The median recovery time was lower in patients with oseltamivir treatment (4 (min 2-max 5) - 5 (min 3-max 10) days) (P < 0.001). CONCLUSION: Rhabdomyolysis is more common in BACM due to the influenza A virus. The early use of oseltamivir treatment was significantly associated with a shorter recovery time.

A Prospective Investigation of Factors Influencing Neonatal Visits to a Tertiary Emergency Department.

OBJECTIVE: Although emergency complaints in newborns are very rare and benign, pediatric emergency department (ED) admissions in Turkey are increasing due to early postpartum discharge and insufficient prenatal care. We aimed to analyze the factors affecting neonatal admissions to ED and to evaluate progress and outcomes following discharge, and hospitalization rates. MATERIALS AND METHODS: All neonates aged 28 days or less admitted to the pediatric ED were included prospectively. Demographics, perinatal-maternal features, and social factors were recorded. Complaints, clinical findings and diagnoses, hospitalization referral rates, and readmission frequencies were analyzed. RESULTS: A total of 2109 neonates were enrolled; the median age was 6 days and 55.7% were males. More than half the newborns (67.5%) visited the ED out of hours, and 99% were non-referral. The frequency of multiparity and cesarean delivery were 48.9% and 57.4%, respectively. The most common complaints were jaundice (66.3%), irritability (9.3%), vomiting (3.4%), and fever (2.6%). While the hospitalization rate was 13%, 12.8% had a serious illness (sepsis, pneumonia, bronchiolitis, etc.). Serious diseases and hospitalization rates were higher among neonates with low birth weight and prematurity (P < .005, P < .001). Mothers who were primiparous and had their pregnancy at a younger age (<21 years) used EDs frequently for non-serious conditions (P < .05, P < .05, respectively). Early postpartum discharge, admission out of hours, age ≤ 7 days, residence in proximity to the hospital, and primiparity were significantly associated with readmission to the ED within 24 hours (P = .001, P < .001, P < .001, P = .014 and P < .001, respectively). CONCLUSION: The admission of neonates to family care physicians and sufficient prenatal and postpartum care will prevent unnecessary referrals to ED and increase the physicians' quality of care for serious diseases in neonates.

A case of May-Thurner Syndrome: An old anomaly but, a new suggestion: A case report.

May-Thurner syndrome (MTS) is an anatomical condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine. MTS is rarely diagnosed because diagnostic workup is seldom continued once the diagnosis of a deep vein thrombosis (DVT) has been established. Furthermore, patients with DVT generally have several well-known confounding risk factors. We report a 16-year-old girl with a history of left leg swelling who was incidentally diagnosed with MTS. We hope that our case report will create awareness of vascular abnormalities in sports medicine and suggest that routine venous Doppler ultrasound screening may help to detect MTS or associated anatomical prior to the formation of early thrombosis.