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    The evaluation of the outcomes of long-term follow-up of patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome
    (Turkiye Klinikleri, 2014) Tekin M.; Toplu Y.; Gülyüz A.; Konca Ç.; Uzuner S.; Üçkardeş F.
    Objective: Evaluation of the long-term outcomes of patients as with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. Material and Methods: In this study, 57 patients admitted to the pediatrics and otorhinolaryngology clinics, and diagnosed as PFAPA syndrome, between 2005 and 2013 were analyzed retrospectively. Age, gender, age of attacks onset, age at diagnosis, frequency of attacks, duration of fever, the major clinical findings, concomitant clinical findings, seasonal difference in attack frequency, concomitant diseases during long term follow-up, the efficiency of single dose prednisolone (1 mg/kg) or tonsillectomy treatment and related resolution rates, and spontaneous remission rates were analyzed. Results: In this retrospective study, 57 patients diagnosed as PFAPA syndrome were followed for an median of 6.1 years (3-8 years). The number of patients whoes the attacks showed no seasonal differences were significantly higher than these showed seasonal differences (p<0.001). Asthma was the most common concomitant diseases with PFAPA syndrome. A single dose of prednisolone (1 mg/kg) was highly effective in controlling symptoms (in 96.4% of patients). Spontaneous remission of fever episodes was observed in twenty six patients during follow-up. The mean duration of disease was 6.6 years, and the mean age of remission was 8.9 years in patients with spontaneous remission. Tonsillectomy or adenotonsillectomy was performed to 10 patients and complete remission was observed in 8 of these patients. Totally 34 (60.7%) patients were recovered spontaneously or after tonsillectomy-adenotonsillectomy. Conclusion: In the long term follow-up, the most cases of patients diagnosed as PFAPA syndrome recovered spontaneously with no sequelae. Single dose of prednisolone (1 mg/kg) was highly effective in controlling symptoms. Tonsillectomy or adenotonsillectomy was very effective for permanent remission. Copyright © 2014 by Türkiye Klinikleri.
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    Investigation of Serum Interleukin 6, High-Sensitivity C-Reactive Protein and White Blood Cell Levels during the Diagnosis and Treatment of Paediatric Appendicitis Patients before and during the COVID-19 Pandemic
    (Wolters Kluwer Medknow Publications, 2023) Gürünlüoglu K.; Zararsiz G.; Aslan M.; Akbas S.; Tekin M.; Gürünlüoglu S.; Bag H.
    Introduction: In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. Materials and Methods: A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared. Results: WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group. Conclusions: Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.