Objectives Multi-system inflammatory syndrome in children (MIS-C) is a less understood and a rare complication of coronavirus disease-2019 (COVID-19). Given the scarce data regarding this novel disease, we aimed to describe the clinical features and outcomes of our patients with MIS-C and to evaluate the associated factors for the pediatric intensive care unit (PICU) admission. Methods The MIS-C patients under 18 years old diagnosed and treated in three referral centers between July 2020 and March 2021 were included. Data of the patients were retrospectively obtained from their medical records. Results Overall, 76 subjects (24 females) with a mean age of 8.17 ± 4.42 years were enrolled. Twenty-seven (35.5%) patients were admitted to the PICUs. The two most common systemic involvement patterns were cardiac and gastrointestinal. There was only one lethal outcome in a patient with underlying acute lymphoblastic leukemia. Those with higher procalcitonin levels at admission were found to stay longer in the hospital (r = 0.254, p = 0.027). The risk of PICU admission increased with age (aOR: 1.277; 95% CI: 1.089-1.498; p = 0.003) and with decreased initial serum albumin levels (aOR: 0.105; 95% CI: 0.029-0.378; p = 0.001). Conclusion Although there is a wide clinical variability among the patients with MIS-C, we suggest that those with older age and lower initial serum albumin levels merit close monitoring due to their higher risk for PICU admission.

Background/Objective: Juvenile spondyloarthropathies (JSpAs) are a group of inflammatory diseases characterized by asymmetric peripheral arthritis (especially in lower extremities), axial skeleton involvement, and enthesitis. Although cardiovascular findings of inflammatory diseases such as juvenile systemic lupus erythematosus (SLE) and juvenile scleroderma (SD) are well documented, there are only a few studies assessing the cardiovascular consequences of JSpA in the literature.Methods: Forty patients with JSpA and 20 healthy controls were included into this cross-sectional study. Cardiac functions of the participants were evaluated by conventional echocardiography and pulse-wave (PW) tissue Doppler.Results: The patients with JSpA had higher mitral lateral S ( p = 0.005) and E' wave ( p < 0.001), tricuspid A' wave ( p = 0.03), ejection fraction ( p = 0.03) and shortening fraction ( p = 0.01) than the control patients. In contrast, the patients with JSpA had lower left ventricle MPI ( p = 0.01) and the ratio of tricuspid E'/A' waves ( p = 0.05). Patients with enthesitis detected on magnetic resonance imaging had lower ejection fraction ( p = 0.05), the ratio of E/A waves ( p = 0.03) and had higher Mitral lateral A' wave ( p = 0.01) than those without. There was a significant inverse correlation between the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and PW transmitral A velocity (r = −0.256, p = 0.03), the BASDAI score and tricuspid annular plane systolic excursion (r = −0.301, p = 0.04), the BASDAI score and the ratio of E/E' waves (r = −0.276, p = 0.02), and the Juvenile Spondyloarthritis Disease Activity Index and PW transmitral A velocity (r = −0.246, p = 0.04). Conclusions:In this study, we report the possible early signs of RV diastolic dysfunction and possible association between magnetic resonance imaging-confirmed enthesitis and lower LV systolic functions. Early identification of cardiac dysfunctions can help with prevention of long-term cardiovascular complications.

Juvenile spondyloarthropathy is an umbrella term for a group of childhood rheumatic diseases that can cause chronic arthritis extending to the axial skeleton before the age of 16. Although ankylosing spondylitis has aortic involvement as one of its most important effects, this relationship has not been extensively studied in children with juvenile spondyloarthropathy. Here, a cross-sectional study of the elastic properties of the aorta of 43 patients with juvenile spondyloarthropathy and 19 healthy controls is reported. Aortic stiffness assessed by echocardiography was used to predict the presence of aortitis, supplemented by pulsed-wave tissue Doppler indices. The right ventricular fractional area change was found to be significantly lower in the patients with juvenile spondyloarthropathy than in the healthy controls; aortic strain and distensibility were also significantly lower, and aortic stiffness index β was significantly higher; and the aortic root diameter change was significantly lower. According to HLA-B27 positivity, there was no difference in the stiffness parameters between the two groups. There was a significant correlation between juvenile Ankylosing Spondylitis Disease Activity Index and aortic diameter change, between juvenile Ankylosing Spondylitis Disease Activity Index and aortic stiffness. Thus, juvenile spondyloarthropathy is linked to high aortic stiffness parameters.

Aim: This study aimed to evaluate the role of real-time three-dimensional (fourdimensional) and speckle tracking echocardiography for early detection of left ventricular systolic dysfunction and also for the relationship between myocardial deformation parameters and myocardial iron load which is measured by cardiac magnetic resonance relaxation time T2* values in asymptomatic children with beta-thalassemia major. Material and Methods:This multicenter cross-sectional study included 40 patients (mean age 15.4 ± 2.9, 42.1% male) and 40 healthy children whose age, gender, and body mass index-matched with patients. Each participant underwent conventional echocardiography and tissue Doppler imaging. Left ventricular ejection fraction; global longitudinal, circumferential, radial strains; twist; and torsion were measured by real-time three-dimensional and speckle tracking echocardiography. Cardiac magnetic resonance imaging T2* was measured in patients.Results: Left ventricular global longitudinal, circumferential, and radial strains were decreased despite preserved global ventricular function in patients compared to healthy children (p = p = .029, p = p < .001, p = .003, respectively). There were no statistically significant differences between patients with T2* ≥ 20 ms and patients with T2* < 20 ms for all echocardiographic parameters. Also, there were no significant correlations between all echocardiographic parameters and T2* values in all patients, those with T2* ≥ 20 ms, and T2* < 20 ms. Conclusion:We found that even in asymptomatic children with beta-thalassemia major, left ventricular longitudinal, circumferential and, radial functions were impaired by real-time three-dimensional (four-dimensional) and speckle tracking

Amaç Bu çalışmada öz kıyım girişimi nedeniyle çocuk acil servise başvuran olguların sosyodemografik özellikleri, öz kıyım girişim yöntemleri ve risk etkenlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler Çalışmamızda Ekim 2014-Nisan 2017 tarihleri arasında Sakarya Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Çocuk Acil Servisi bölümüne intihar girişimi nedeniyle başvuran ve "İntihar Girişimleri Kayıt Formu" doldurulan 18 yaş altı 383 olgunun kayıtları cinsiyet, yaş, yerleşim bölgesi, eğitim durumu, intihar girişimi için kullanılan yöntem ve tetikleyici faktörler, girişim sayısı, psikiyatrik tanı, takip ve tedavi öyküleri açısından retrospektif olarak değerlendirilmiştir. Bulgular Çalışmaya alınan 383 vakadan 330(%86,2)'u kız ve vakaların yaş ortancası 15(12-18) yıl bulundu. Vakaların çoğunluğu lise öğrencisi idi (%56,9). Vakaların tamamının ilaçtoksik madde ile öz kıyım girişiminde bulunduğu görüldü. Vakalardan 326(%85,1)'sının ilk defa, 57(%14,9)'sinin ise birden çok öz kıyım girişiminde bulunduğu izlendi. Öz kıyım nedenlerinin en sık ailesel sorunlar(%60,6), ardından gelişim dönemi sorunları (%18,5) olduğu gözlendi. 27(%7) vakanın daha önce psikiyatrik bir hastalık tanısı bulunurken, 356(%93) vakanın psikiyatrik bir tanısının olmadığı görüldü. Vakaların çoğunluğunun şehir merkezinde yaşadığı görüldü (%92,4). Öz kıyım girişimlerinin en sık (%30,5) ilkbahar mevsiminde olduğu gözlendi. Başvuru saatlerine göre hastaların en sık 20.00-24.00 arasında başvurduğu tespit edildi. Sonuç Sonuç olarak, hayatı tehdit eden bir problem olan öz kıyım girişimi ile ilgili risk faktörleri bir bütün olarak ele alınarak, çocuklara uygun koruyucu, destekleyici ve tedavi edici yaklaşımlar açısından değerlendirilmelidir.