The Turkish journal of pediatrics最新文献

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Evaluating the reliability and validity of the Turkish version of the Parents' Perceptions of Uncertainty Scale (PPUS-TR). 评估土耳其版父母不确定性感知量表(PPUS-TR)的信度和效度。
The Turkish journal of pediatrics Pub Date : 2025-05-05 DOI: 10.24953/turkjpediatr.2025.5470
Melike Ayça Ay Kaatsız, Simay Ezgi Budak
{"title":"Evaluating the reliability and validity of the Turkish version of the Parents' Perceptions of Uncertainty Scale (PPUS-TR).","authors":"Melike Ayça Ay Kaatsız, Simay Ezgi Budak","doi":"10.24953/turkjpediatr.2025.5470","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5470","url":null,"abstract":"<p><strong>Background: </strong>The disease process can negatively affect both children and their parents, causing them to experience uncertainty. This study aims to determine whether the Turkish version of the Parents' Perceptions of Uncertainty Scale (PPUS) is a valid and reliable instrument for measuring Turkish parents' perceptions of uncertainty.</p><p><strong>Methods: </strong>Data were collected from 351 parents. Data collection tools included the Descriptive Data Form, PPUS, and the Brief Symptom Inventory (BSI). Language, face, and content validity, descriptive statistics, internal consistency analyses, explanatory and confirmatory factor analyses, and convergent validity analyses were conducted.</p><p><strong>Results: </strong>The content validity index (CVI) was calculated as 0.96. As a result of the exploratory factor analysis, a four-factor structure with 23 items explaining 57.98% of the total variance was obtained. Confirmatory factor analysis supported the model fit. The Cronbach's alpha coefficient for the final version of the scale was 0.923. Convergent validity showed a significant positive relationship with the BSI (r=0.69).</p><p><strong>Conclusions: </strong>The Turkish version of PPUS (PPUS-TR) was found to be a valid and reliable measurement tool.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"230-241"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increased serum YKL-40 levels in children with sickle cell disease. 镰状细胞病患儿血清YKL-40水平升高
The Turkish journal of pediatrics Pub Date : 2025-05-05 DOI: 10.24953/turkjpediatr.2025.4805
Veysi Akbey, Selma Ünal, Özlem Tezol, Bahar Taşdelen, Şenay Balcı Fidancı, Feryal Karahan
{"title":"Increased serum YKL-40 levels in children with sickle cell disease.","authors":"Veysi Akbey, Selma Ünal, Özlem Tezol, Bahar Taşdelen, Şenay Balcı Fidancı, Feryal Karahan","doi":"10.24953/turkjpediatr.2025.4805","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.4805","url":null,"abstract":"<p><strong>Background: </strong>YKL-40 is a glycoprotein secreted by various cell lines during inflammation and vascular dysfunction. Sickle cell disease (SCD) also involves inflammation and endothelial dysfunction processes. Thus, we aimed to assess the levels of YKL-40 in pediatric SCD patients.</p><p><strong>Methods: </strong>We evaluated serum levels of YKL-40 in children with steady state SCD and those with vaso-occlusive crisis (VOC) episodes and compared them with healthy subjects.</p><p><strong>Results: </strong>Overall, 33 children with SCD and 33 healthy controls participated in this study. Serum YKL-40 concentrations of children with steady state SCD were significantly higher than the concentrations found in the healthy controls (median [Q1-Q3]: 71.0 [53.3-133.3] vs. 43.6 [37.9-69.9] ng/mL, p=0.001). Seventeen of the 33 children with SCD (51.5%) had a VOC during the one-year follow-up period. Steady state and VOC episode YKL-40 did not significantly differ in children who were experiencing VOC during the one-year follow-up (77.6 [55.2-126.8] vs. 69.7 [49.3-100.0] ng/mL, p=0.381). During VOC episodes, children with SCD had significantly higher YKL-40 levels than the healthy controls (69.7 [49.3-100.0] vs. 43.6 [37.9-69.9] ng/mL, p=0.005). YKL-40 levels at steady state and during VOC episodes did not show significant correlation (p=0.955).</p><p><strong>Conclusions: </strong>YKL-40 may have a potential role in the inflammation component of SCD. Circulating YKL-40 levels may be used to monitor chronic inflammation in SCD patients.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"186-194"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring quality of life and related clinical factors in children with tree nut allergies. 探讨树坚果过敏儿童的生活质量及相关临床因素。
The Turkish journal of pediatrics Pub Date : 2025-05-05 DOI: 10.24953/turkjpediatr.2025.5293
Zehra Genç Özbay, Ayşegül Akarsu, Ümit Murat Şahiner, Özge Uysal Soyer, Bülent Enis Şekerel
{"title":"Exploring quality of life and related clinical factors in children with tree nut allergies.","authors":"Zehra Genç Özbay, Ayşegül Akarsu, Ümit Murat Şahiner, Özge Uysal Soyer, Bülent Enis Şekerel","doi":"10.24953/turkjpediatr.2025.5293","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5293","url":null,"abstract":"<p><strong>Background: </strong>In Türkiye, tree nut allergy (TNA) is the most common form of food allergy, characterized by persistence and the potential for life-threatening reactions. This study aimed to evaluate the quality of life (QoL) of Turkish children aged 0-12 years with IgE-mediated TNA and explore influential factors, including parental anxiety.</p><p><strong>Materials and methods: </strong>Primary caregiver-parents of children diagnosed with TNA completed the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) and State-Trait Anxiety Inventory (STAI) to assess QoL and parental anxiety, respectively.</p><p><strong>Results: </strong>Of 120 eligible patients diagnosed with TNA, 88 were included in the study. Questionnaires were completed by mothers in 79 cases (90%) and fathers in 9 cases (10%). Parents reported significantly higher FAQLQ-PF scores for children with hazelnut allergy, a history of anaphylaxis, and those who had to use an adrenaline auto-injector. There was significant but weak correlations between FAQLQ-PF and anxiety (STAI) domains. The multivariate linear regression analysis revealed that having a hazelnut allergy, a history of anaphylaxis, and higher parental state anxiety were all associated with higher FAQLQ-PF scores, but fathers tended to report better level of QoL.</p><p><strong>Conclusion: </strong>QoL for children with TNA is influenced by several factors such as adverse life experiences, local and situational factors, and parental anxiety. Understanding these diverse factors is crucial for enhancing the well-being of children with TNA.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"195-207"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comprehensive analysis of 1103 infants referred to a single center due to positive newborn screening test for phenylketonuria. 对因新生儿苯丙酮尿筛查试验阳性而转诊至单一中心的1103例婴儿的综合分析。
The Turkish journal of pediatrics Pub Date : 2025-05-05 DOI: 10.24953/turkjpediatr.2025.5263
Ayça Burcu Kahraman, Kısmet Çıkı, Begüm Poşul, Mustafa Güvercin, Yılmaz Yıldız, Ali Dursun, Serap Sivri, Turgay Coşkun, Ayşegül Tokatlı
{"title":"Comprehensive analysis of 1103 infants referred to a single center due to positive newborn screening test for phenylketonuria.","authors":"Ayça Burcu Kahraman, Kısmet Çıkı, Begüm Poşul, Mustafa Güvercin, Yılmaz Yıldız, Ali Dursun, Serap Sivri, Turgay Coşkun, Ayşegül Tokatlı","doi":"10.24953/turkjpediatr.2025.5263","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5263","url":null,"abstract":"<p><strong>Objective: </strong>Phenylketonuria (PKU) is a prevalent inherited metabolic disorder, resulting from biallelic pathogenic variants in the PAH gene. This study aimed to assess the clinical characteristics of 1103 infants referred to a single center due to positive newborn screening (NBS) tests for PKU, providing insights into screening and diagnosis.</p><p><strong>Methods: </strong>The health records of infants who were referred with suspicion of PKU through the Turkish national NBS program to a single referral center between January 2016 and January 2023 were retrospectively reviewed. The study analyzed demographic data, clinical findings, and diagnostic results from hospital records. Logistic regression analysis identified significant predictors of age at admission.</p><p><strong>Results: </strong>This study highlights significant regional differences within Türkiye regarding DBS collection, result reporting, and age at admission. Significant delays in age at admission (expressed as median, [Q1-Q3]) were noted in the Eastern Anatolia (34 days [27-42]), Southeastern Anatolia [34 days (25-42)], and Black Sea regions [26 days (19-33)]. Out of the referred infants, 5.1% and 2.4% had transient tyrosinemia and transient hyperphenylalaninemia, respectively, and these transient conditions were more prevalent among neonates with a history of jaundice. Phenylalanine level was normal in 38.1% of the patients and was considered false positive. Among the 26 (2.36%) patients admitted after 90 days (late admissions), there were 2 PKU patients with untreated Phe levels >20 mg/dL (n=2). Among the 140 infants requiring treatment, 1.43% (n=2) were late admissions (>90 days). A history of PKU in the family and higher initial Phe levels were associated with earlier admissions.</p><p><strong>Conclusion: </strong>This comprehensive analysis underscores the need to enhance NBS programs, particularly in regions with identified delays. Improving healthcare infrastructure, increasing awareness, and implementing targeted health policies are crucial for timely diagnosis and treatment. Future research should address regional disparities and optimize screening protocols to improve outcomes for affected infants.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"175-185"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inflammatory marker comparison in childhood brucellosis: predicting osteoarticular involvement. 儿童布鲁氏菌病的炎症标志物比较:预测骨关节受损伤。
The Turkish journal of pediatrics Pub Date : 2025-05-05 DOI: 10.24953/turkjpediatr.2025.5811
Elif Böncüoğlu, Şadiye Kübra Tüter Öz, Zafer Bağcı
{"title":"Inflammatory marker comparison in childhood brucellosis: predicting osteoarticular involvement.","authors":"Elif Böncüoğlu, Şadiye Kübra Tüter Öz, Zafer Bağcı","doi":"10.24953/turkjpediatr.2025.5811","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5811","url":null,"abstract":"<p><strong>Background: </strong>Although the use of inflammatory markers in diagnosing Brucella-related complications has been the subject of research, studies on osteoarticular disease are insufficient, especially in children. This study aimed to compare inflammatory markers in children diagnosed with brucellosis, distinguishing between those with and without osteoarticular involvement (OI).</p><p><strong>Methods: </strong>In this retrospective study, patients diagnosed with brucellosis from 1 month to 18 years of age were evaluated. Data collected included age, gender, OI, treatment duration, complete blood count, inflammatory markers including neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and Brucella serum agglutination test (SAT) results. OI was confirmed by MRI in symptomatic patients. The results of patients with and without OI were compared.</p><p><strong>Results: </strong>The study included 38 patients, 23.7% having OI (8 with sacroiliitis and 1 with spondylitis). The median age of patients with OI was significantly higher than those without (p=0.037). All patients with OI (n = 9, 100%) had an SAT titer ≥ 1/640. Among patients without OI, 62% (n = 18) had an SAT titer ≥1/640. This difference was statistically significant (p = 0.028). Patients with OI had higher CRP levels (p=0.038) but similar ESR levels compared to those without. WBC levels were significantly lower in the group with OI (p=0.015). NMR was significantly higher in those with OI (p=0.012).</p><p><strong>Conclusions: </strong>Lower WBC counts and higher CRP and NMR levels can predict OI in children with brucellosis at the time of admission. However, our findings should be validated through prospective studies involving larger patient groups.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"248-253"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cornell Assessment of Pediatric Delirium: Turkish translation and validation. 康奈尔评估儿童谵妄:土耳其语翻译和验证。
The Turkish journal of pediatrics Pub Date : 2025-05-05 DOI: 10.24953/turkjpediatr.2025.5237
Emel Uyar, Nurettin Onur Kutlu, Elif Akçay, Gülser Dinç, Merve Onat, Esra Koçkuzu, Yavuz Meral, Chani Traube
{"title":"Cornell Assessment of Pediatric Delirium: Turkish translation and validation.","authors":"Emel Uyar, Nurettin Onur Kutlu, Elif Akçay, Gülser Dinç, Merve Onat, Esra Koçkuzu, Yavuz Meral, Chani Traube","doi":"10.24953/turkjpediatr.2025.5237","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5237","url":null,"abstract":"<p><strong>Background: </strong>Hypoactive delirium may go unrecognized unless routinely screened. At present, there is no valid screening tool for delirium in the Turkish language. This study was conducted to translate the Cornell Assessment of Pediatric Delirium (CAPD) into Turkish and to evaluate its validity and reliability.</p><p><strong>Methods: </strong>In this is validation study, CAPD assessments were conducted by pediatric intensive care unit nurses and compared with assessments by a child psychiatrist.</p><p><strong>Results: </strong>A total of 76 patients were included, 37 participants (48.6%) were younger than 24 months, and 22 participants (28.9%) had developmental disabilities. Prevalence of delirium was 25.0% (n=19). Inter-rater agreement for the identification of delirium by psychiatrists was strong and reliable, with a Cohen's kappa value of 0.86 (95% confidence interval [CI]: 0.72-0.99). Inter-rater reliability for nurses was also significant, with a Cohen's kappa of 0.74 (95% CI, 0.57-0.91). Inter-rater reliability ranged from 0.64 to 0.84 for each CAPD item except item 6, indicating reliable scoring. Sensitivity and specificity improved when the CAPD cut-off score was increased from 9 (100% and 95%, respectively) to 11 (100% and 98.02%, respectively). Subgroup analyses showed high sensitivity and specificity in patients with developmental delay (96%) and in patients under 2 years of age (96%) when the CAPD cut-off score was 9. However, specificity decreased slightly to 93% in patients under 6 months of age.</p><p><strong>Conclusion: </strong>The Turkish CAPD, the first delirium screening scale translated into Turkish, has demonstrated validity and reliability in screening for delirium in children of all ages, including those with developmental disabilities.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"221-229"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of miR-149 gene rs2292832 polymorphism with necrotizing enterocolitis in preterm infants. miR-149基因rs2292832多态性与早产儿坏死性小肠结肠炎的关系
The Turkish journal of pediatrics Pub Date : 2025-05-04 DOI: 10.24953/turkjpediatr.2025.5653
Hong Qiu, Xiaojun Wang, Yanhong Li, Renping Mao, Qin Lv
{"title":"Association of miR-149 gene rs2292832 polymorphism with necrotizing enterocolitis in preterm infants.","authors":"Hong Qiu, Xiaojun Wang, Yanhong Li, Renping Mao, Qin Lv","doi":"10.24953/turkjpediatr.2025.5653","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5653","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) is a prevalent and challenging intestinal disease in premature infants, lacking a specific pathogen consistently associated with its occurrence. Effectively preventing and treating NEC to reduce mortality rates remains a significant contemporary challenge. The present study aimed to explore the correlation between microRNA-149 gene polymorphism and NEC in premature infants in a Chinese Han population.</p><p><strong>Methods: </strong>The expression levels of serum miR-149 were determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Polymorphism detection of the miR-149 gene rs2292832 polymorphism was performed by polymerase chain reaction. Multivariate logistic regression analysis was employed to investigate the association between the rs2292832 polymorphism and risk factors for NEC in preterm infants.</p><p><strong>Results: </strong>General clinical data were compared between 102 preterm infants diagnosed with NEC and 263 preterm infants without NEC. Significant differences were observed in gestational age and birth weight. However, no significant differences were found in antenatal steroid use, sex, or feeding patterns between the two groups. The expression level of serum miR-149 was significantly reduced in premature infants with NEC, and there were differences in the allele frequency of the miR-149 rs2292832 polymorphism between the NEC group and control group. Specifically, the T allele and TT genotype of rs2292832 were associated with an increased susceptibility to NEC. Furthermore, both gestational age and the rs2292832 polymorphism showed a significant association with NEC risk, with the rs2292832 polymorphism of miR-149 being identified as the most prominent risk factor for NEC development in preterm infants.</p><p><strong>Conclusions: </strong>The rs2292832 gene polymorphism of miR-149 may potentially exert an influence on susceptibility to NEC.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"144-152"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Duchenne muscular dystrophy with Kocher-Debre-Semelaigne syndrome: a double jeopardy. 杜氏肌营养不良伴Kocher-Debre-Semelaigne综合征:双重危险。
The Turkish journal of pediatrics Pub Date : 2025-05-04 DOI: 10.24953/turkjpediatr.2025.5488
Arumugom Archana, Pediredla Karunakar, Vaishnavi Sreenivasan, Reena Gulati
{"title":"Duchenne muscular dystrophy with Kocher-Debre-Semelaigne syndrome: a double jeopardy.","authors":"Arumugom Archana, Pediredla Karunakar, Vaishnavi Sreenivasan, Reena Gulati","doi":"10.24953/turkjpediatr.2025.5488","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5488","url":null,"abstract":"<p><strong>Background: </strong>Duchenne muscular dystrophy (DMD) is a progressive X-linked dystrophinopathy with onset in early childhood. Affected individuals present predominantly with proximal lower limb weakness and pseudohypertrophy of calf musculature being a prominent sign, heralding the onset of contractures in the large joints of lower limbs. Kocher-Debre-Semelaigne syndrome (KDSS) refers to the muscular pseudohypertrophy that develops in children with long-standing hypothyroidism.</p><p><strong>Case presentation: </strong>We present an 11-year-old boy with progressive walking difficulty for two years and associated decrease in appetite and chronic constipation. Physical examination revealed mild soft goitre, proximal lower limb weakness, areflexia (except for preserved weak ankle reflex), soft hypertrophy of bilateral calf muscles and latissimus dorsi, with bilateral dynamic ankle joint contractures. Investigations showed moderately elevated total serum creatine phosphokinase (CPK) levels, elevated serum thyroid stimulating hormone (TSH), low free T4, normal free T3 and elevated serum anti-thyroid peroxidase and anti-thyroglobulin antibody titers. A diagnosis of hypothyroidism secondary to Hashimoto's thyroiditis with Kocher-Debre-Semelaigne syndrome (KDSS) (thyroid myopathy) was made while multiplex ligation-dependent probe amplification confirmed DMD. He was started on steroids and levothyroxine. On follow up, he had improvement in activity, appetite and motor movements (North Star Ambulatory Assessment score 3 to 7).</p><p><strong>Conclusion: </strong>As a very rare coincidence, our patient suffered from two different diseases with similar presentation which are DMD and KDSS. Subtle clinical clues of joint contractures and goitre helped us identify these unrelated co-existing diseases. An alternate diagnosis must be thought of when all clinical findings cannot be explained by a single disease.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"268-272"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Blocked D phenomenon implicated in a diagnostic dilemma in RhD-hemolytic disease affecting twins: case report and review of literature. 在影响双胞胎的rhd -溶血性疾病中涉及诊断困境的阻断D现象:病例报告和文献回顾
The Turkish journal of pediatrics Pub Date : 2025-05-04 DOI: 10.24953/turkjpediatr.2025.5786
Abid Ali, Laxman Basany, G Naga Priyanka, Ravinder Reddy Lotkal
{"title":"Blocked D phenomenon implicated in a diagnostic dilemma in RhD-hemolytic disease affecting twins: case report and review of literature.","authors":"Abid Ali, Laxman Basany, G Naga Priyanka, Ravinder Reddy Lotkal","doi":"10.24953/turkjpediatr.2025.5786","DOIUrl":"10.24953/turkjpediatr.2025.5786","url":null,"abstract":"<p><strong>Background: </strong>The Rh blood group system is the most common cause of hemolytic disease of the fetus and newborn (HDFN). Rh antigens are fully expressed at birth unlike ABO antigens which are weakly expressed. Sensitization to the D antigen can occur with exposure to < 0.1 mL of fetal blood. In rare cases of HDFN, these passively transferred IgG anti-D antibodies coat the D antigens on the newborn's red blood cells and interfere with the agglutination of D-positive red cells when tested with IgM anti-D typing reagents, resulting in false-negative Rh(D) typing. This \"blocked D phenomenon,\" can pose a diagnostic challenge.</p><p><strong>Case presentation: </strong>This case report describes twins with HDFN born to a Rh(D) negative mother. Both cord blood and neonatal blood were incorrectly typed as Rh(D) negative using routine typing reagents, creating a diagnostic dilemma. The combination of a positive direct antiglobulin test (DAT), the mother's RhD-negative status, a positive indirect antiglobulin test (IAT), and discordant or unexpected RhD typing in the neonate raised suspicion of blocked D phenomenon. Paired samples from the parents and neonates were analysed. Following gentle heat elution at 45°C for 10 minutes, the neonatal red cells were re-typed as RhD positive using the conventional tube technique with monoclonal IgM anti-D. At the 6-month follow-up, both infants were phenotyped as O RhD positive.</p><p><strong>Conclusions: </strong>The possibility of the blocking phenomenon should be considered while interpreting blood group results from fetal or neonatal samples in an alloimmunized pregnancy with potent antibodies. All pregnant women, regardless of their RhD type, should be tested for clinically significant unexpected serum antibodies during pregnancy. Elution methods help in identifying correct D antigen when Rh(D) typing gives uncertain results. Antiglobulin testing with anti-IgG should be performed to detect antibodies causing hemolytic disease of the fetus and newborn (HDFN).</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"259-267"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Escherichia coli pseudo-outbreak in the intensive care units of a university hospital. 在一所大学医院的重症监护室发生了一次假大肠杆菌爆发。
The Turkish journal of pediatrics Pub Date : 2025-05-04 DOI: 10.24953/turkjpediatr.2025.5347
Burcu Parlak, Sevliya Öcal Demir, Seyhan Yılmaz, Sevgi Aslan Tuncay, Pınar Canizci Erdemli, Aylin Dizi Işık, Nazlı Pazar, Işıl Küçüker, Zeynep Ergenç, Hüseyin Bilgin, Feyza İnceköy Girgin, Gülşen Akkoç, Eda Kepenekli
{"title":"An <i>Escherichia coli</i> pseudo-outbreak in the intensive care units of a university hospital.","authors":"Burcu Parlak, Sevliya Öcal Demir, Seyhan Yılmaz, Sevgi Aslan Tuncay, Pınar Canizci Erdemli, Aylin Dizi Işık, Nazlı Pazar, Işıl Küçüker, Zeynep Ergenç, Hüseyin Bilgin, Feyza İnceköy Girgin, Gülşen Akkoç, Eda Kepenekli","doi":"10.24953/turkjpediatr.2025.5347","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2025.5347","url":null,"abstract":"<p><strong>Background: </strong>The term 'pseudo-outbreak' refers to a condition in which a microorganism is found in cultures at a greater rate than expected due to contamination of materials that would normally be sterile. This situation cannot be clinically correlated with the infection suggested by the culture results. This can be confusing depending on the patient's clinical condition, especially in intensive care units (ICU). The pseudo-outbreak with Escherichia coli in patients in ICUs will be discussed in this study to emphasize the importance of strict adherence to microbiology policies and procedures.</p><p><strong>Methods: </strong>In September 2022, growths of Escherichia coli were found in the endotracheal aspirate cultures of six children and eighteen adults in the ICU.</p><p><strong>Results: </strong>The identification of the same microbial agent in 24 patients prompted an investigation into a potential outbreak. The infection control committee compiled a comprehensive patient list to facilitate the assessment. Given that the healthcare personnel and infrastructure of each ICU were distinct and functioned independently, the possibility of cross-contamination within these units was deemed unlikely. Consequently, attention was directed toward the microbiology laboratory as a potential source of the outbreak. A thorough review of culture processing steps and laboratory equipment was conducted. This investigation revealed that the saline solution used for the passage of endotracheal aspiration cultures was contaminated, suggesting a laboratory-associated contamination event as the probable cause.</p><p><strong>Conclusions: </strong>By strictly adhering to the latest protocols, the disinfection and sterilization chain can ensure the safe use of both invasive and non-invasive medical equipment. This manuscript aims to raise awareness among pediatricians and pediatric infectious disease specialists regarding the occurrence of pseudo-outbreaks. A pseudo-outbreak is indicative of a disruption in the sterilization chain.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"67 2","pages":"242-247"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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