E-ISSN: 2791-8823
Volume: 2  Issue: 2 - August 2022

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Merih Cetinkaya
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3.Persistent Neurocognitive Problems Related to COVID-19 in Children and Adolescents
Caner Mutlu, Esra Rabia Tapolat
doi: 10.4274/csmedj.galenos.2022.2022-7-1  Pages 38 - 48
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has caused persistent multisystemic symptoms. Data on the long-term effects of coronavirus disease-2019 (COVID-19) in children and adolescents are scarce. Persistent neurocognitive symptoms are important for the functionality of children in daily life. This review assessed the literature regarding the frequency, pathology, risk factors, and prognosis of the long-term neurocognitive effects of COVID-19 in the pediatric population. This review demonstrated that children and adolescents had various persistent neurocognitive problems related to COVID-19. The heterogeneity of studies prevents from drawing firm conclusions, as there were differences between study populations and designs in terms of disease severity and time of assessment. Because the pandemic is a recent event, long‐term follow‐ups to establish how long cognitive impairment persists after COVID‐19 recovery are still impossible.

4.Overall and Event-free Survival in Children with Acute Lymphoblastic Leukemia and Evaluation of Treatment Related Acute Toxicity
Orhan zdoan, Ali Ayiek, Sibel Tekgndz, Ezgi Pasl Uysalol, Mge Gke, Cengiz Bayram
doi: 10.4274/csmedj.galenos.2022.2022-1-4  Pages 49 - 58
Objective: The study aimed to evaluate the acute toxicity, overall survival (OS) and event-free survival (EFS) of children with acute lymphoblastic leukemia (ALL).
Material and Methods: This study included retrospective analysis of the medical records of 129 pediatric ALL patients aged 1 to 18 years old. Gender, risk group, central nervous system involvement at diagnosis, relapse and mortality status of patients, OS and EFS was evaluated. The Kaplan-Meier method was used to estimate survival rates. The survival difference of two groups was compared using the log-rank test.
Results: Eighty-six (66%) patients were boys and forty-three (33%) were girls. The mean age at diagnosis was 6.94.46 and 5.64.01 in male and female, respectively. Seventeen (13%) patients were classified as standard risk, 76 (58%) were intermediate risk, and 36 (27%) were high risk. Three patients (2.3%) died from acute toxicity during induction therapy. The median duration of follow-up was 25 months (range 1-65 months). The estimated 5-year OS and EFS was 884.6% and 784.1%, respectively. The estimated 5-year OS for the standard, intermediate and high-risk groups were 945.7%, 933.1%, and 5913%, respectively, and EFS was 945.7%, 86.64.2%, and 49.910%, respectively.
Conclusion: The OS and EFS for standard-risk and intermediate-risk groups were good and comparable to the literature. However, the current studys results should be confirmed in a larger patient population and a longer follow-up period.

5.Evaluation of the Adequacy of Blood Mixing by Echocardiographic Parameters in Neonates with the Transposition of Great Arteries
Erkut ztrk, brahim Cansaran Tandr
doi: 10.4274/csmedj.galenos.2022.2022-5-1  Pages 59 - 64
Objective: Transposition of the great arteries (TGA) is one of the major causes of cyanotic heart disease in neonates and should be treated surgically in the early stages of life. In these patients, adequate blood mixing between systemic and pulmonary blood flow is required until surgery, and interatrial communication plays a major role during this period. This study aimed to evaluate the echocardiographic factors used to predict adequate interatrial communication with echocardiographic data.
Material and Methods: This study included newborn patients (who were) followed up in the pediatric cardiac intensive care unit with the diagnosis of simple TGA between August 1, 2020, and February 1, 2021. Patients were classified into those who underwent balloon atrial septostomy (BAS) (group I) and those who did not undergo BAS (group II). The atrial septal defect (ASD) size, interatrial septum (IAS) length, peak/mean interatrial pressure gradient, transverse diameter of the left atrium (LA), transverse diameter of the right atrium (RA), and the following ratios; ASD/IAS, LA/RA, mitral/tricuspid valve annulus, peak gradient of ASD/ASD diameter and ASD diameter/(LA: RA ratio) were calculated echocardiographically. The results were evaluated statistically.
Results: Eighteen patients were included (6 patients in group I and 12 patients in group II) during the study period. The median age was 3 days (interquartile range 2 days-7 days). 50% of the cases were male, and 50% were female. ASD peak gradient, ASD mean gradient, ASD peak gradient/ASD diameter, and LA: RA ratios were significantly higher, and ASD size, ASD diameter/(LA: RA ratio) were significantly lower in the group I compared in group II (p<0.05). ASD diameter/(LA: RA ratio) was found to independently predict the need for BAS with a cut-off value of 2.7 by multivariate analysis.
Conclusion: The echocardiographic measurement of ASD diameter/(LA: RA ratio) in TGA patients may be helpful in the prediction of BAS requirement.

6.Asepsis Techniques Prior to Amniocentesis; Which Technique is Better?
Il Uzun ilingir, Fusun Varol, Havva St, Cihan nan, Selen Erzincan, Cenk Sayn
doi: 10.4274/csmedj.galenos.2022.2022-5-2  Pages 65 - 69
Objective: The aim of this study was to analyze the indications of second-the trimester amniocentesis in a tertiary center and evaluate the difference between aseptic techniques before amniocentesis.
Material and Methods: The study sample was drawn from the patients who had amniocentesis between 16th and 22th weeks of pregnancy at Trakya University high-risk pregnancy unit between 2015 and 2018. The patients were divided into two groups according to the antiseptic solutions, which used before the operation. Group I comprised of patients in whom 10% povidine- iodine solution was used for aseptic skin preparation. Group II consisted of patients in whom 10% povidine- iodine solution with 70% isopropyl alcohol solution was used.
Results: One hundred fifty eight patients were in group I and took 10% povidine- iodine solution was used for aseptic skin preparation before the procedure and 119 (42.9%) patients were in group II and 10% povidine-iodine +2% chlorhexidine gluconate were used for skin preparation. There were no fetal loss in either group. Two patients (0.7%) in group II was admitted to the hospital in the first week after amniocentesis with increased vaginal discharge and slight abdominal pain.
Conclusion: Although the lack of evidence for the superiority of any asepsis technique, a combination of aseptic solutions may be an option for the patients with a high risk of fetal loss.

7.Ultrasound-guided Breast Biopsy: Evaluation of the Correlation Between Radiologic and Histopathologic Findings
Handan Eren, Tuce Soylemez Akkurt, Hazal Izol Ozmen, Mehmet Ali Nazli, Ebru Sen, Soykan Arikan, Burcin Pehlivanoglu
doi: 10.4274/csmedj.galenos.2022.2021-12-5  Pages 70 - 74
Objective: Image-guided breast biopsy is commonly used for diagnosis of breast lesions. Breast ultrasound (US), which is also used for screening purposes, is an important tool to guide biopsies. In this study, we evaluated the radiologic-histopathologic correlation in patients who underwent US-guided breast biopsy.
Material and Methods: A total of 126 biopsies from 116 consecutive cases were included. Patients US and histopathological findings were retrospectively reviewed.
Results: All patients were female. Median age was 4412 (range; 16-66 years old). Two patients (2%) had bilateral, 8 (7%) had multifocal lesions. Breast Imaging Reporting and Data System (BI-RADS) was used for 115 lesions (91%). Three cases (2%) were BI-RADS 2, 27% (n=34) BI-RADS 3, 35% (n=44) BI-RADS 4, 25% (n=32) BI-RADS 5 and 2% (n=2) BI-RADS 6. Eight biopsies composed of normal breast tissue, which had been scored as BI-RADS 3 or 4, were considered inadequate. More than one-third (37%; n=47) were malignant as 28% (n=35) were consistent with fibroepithelial lesions and 11% (n=14) with inflammatory lesions. Major radiologic-histopathologic discordance was observed in only 2 cases, while there was minor discordance in 14. Ten of the 14 cases (11%) with minor discordance were BI-RADS 4 lesions and minor discordance was more common for benign lesions (p=0.013).
Conclusion: Our findings demonstrate a high radiologic-histopathologic correlation rate in US-guided breast biopsy samples. We observed the highest discordance in BI-RADS 4 lesions, suggesting that histopathological verification is necessary in patients with BI-RADS 4 lesions to exclude malignancy.

8.Lovebird-induced Aspergillus Infection in a Child with Chronic Granulomatous Disease
idem Aydomu, Hatice Nursoy, Sevgi Yavuz, Abdurrahman Glmez, Selda Kme
doi: 10.4274/csmedj.galenos.2022.2022-1-1  Pages 75 - 79
Chronic granulomatous disease (CGD) is a primary immune deficiency in which the phagocytic system is affected. The disease is inherited X-linked or autosomal recessive and is characterized by life-threatening bacterial and fungal infections. Invasive fungal infections are one of the most important causes of mortality in this disease. Here, we discuss an 8-year-old male patient with CGD considering literature. The patient developed invasive aspergillus infection due to the pet bird. Here, it is aimed to emphasize that pets may be a possible source of Aspergillus infection in people with CGD and that surgically obtained tissue cultures may be required for diagnosis.

9.Diffuse Bone Marrow Involvement of Langerhans Cell Histiocytosis Detected with F-18 FDG PET/CT
Elife Akgn, Furkan Gr, Burak Yilmaz
doi: 10.4274/csmedj.galenos.2022.2022-4-1  Pages 80 - 81
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