Association of depression and social anxiety symptom scores with disease characteristics in pediatric patients with chronic immune thrombocytopenia: a cross-sectional study.

Patients with ITP have been reported to experience higher levels of depression and anxiety than their healthy counterparts. The limited research conducted on this subject in the pediatric age group has demonstrated that patients have psychosocial difficulties, and their quality of life is adversely affected. The correlation of depressive symptoms with disease characteristics of cITP has never been investigated. This was a cross-sectional study in patients being treated for cITP. Communication with participants was done during routine outpatient visits or by telephone or e-mail, and a survey about demographics and the Children's Depression Inventory (CDI) and the Social Anxiety Scale for Children-Revised (SAS-CR) was administered prospectively. A total of 56 children with cITP were recruited. The mean CDI score was 17 (SD: ± 9.44). Approximately half of the patients had higher CDI scores than healthy Turkish children. Older age, time since diagnosis, a number of hospitalizations (both total and within the last year) were positively correlated with CDI scores. There was no significant correlation between SAS-CR scores and disease characteristics. Depressive symptom scores were higher in children with cITP compared with healthy children in this study. Psychological needs may be overlooked in the medical management of children with cITP.

Assessing Psychological Disorders in Turkish Adolescents with Transfusion-Dependent Thalassemia.

We investigated depression and anxiety levels and related psychological disorders in adolescents with transfusion-dependent thalassemia (TDT) in this study. The study was conducted in two pediatric hematology outpatient clinics and included adolescents with TDT (14.8 ± 2.4 years, n = 40) in the study and compared them with the healthy age-matched control group (14.3 ± 2.3 years, n = 62). The Turkish version of the Revised Child Anxiety and Depression Scale (RCADS) was used to determine depression, anxiety, and related psychologic disorders (obsession, panic disorder, social phobia). Depression, anxiety, obsession, panic disorder, and social phobia scores were significantly higher in the patient group compared with the control (all p < 0.05). Ferritin levels were positively correlated with total depression, general anxiety, separation anxiety, and social phobia scores, but transfusion frequency and young age were the confounding factors. Patients in early adolescence and those who require more frequent blood transfusions are at higher risk of developing psychological disorders; routine screening for mood disorders should be warranted. Serum ferritin level may be a good warning indicator for early recognition of psychologic disorders in TDT patients.

Evaluation of inflammatory hematological ratios (NLR, PLR, MLR and Monocyte/HDL-Cholesterol Ratio) in obese adolescents / Evaluación de las relaciones hematológicas inflamatorias (NLR, PLR, MLR y relación monocitos / colesterol HDL) en adolescentes obesos

Introduction: Obesity is a gradually more important multifactorial disease in both children and adults. Obese children and adolescents are at higher risk of becoming obese in adulthood, which is associated with an increased risk of mortality and morbidity. There is subclinical systemic inflammation in obesity. The study aimed to evaluate the hematological parameters as an indicator of inflammation in obese adolescents and to show the relationship of monocyte/HDL-cholesterol ratio, having a lipid component, with other inflammatory hematological parameters. Materials and methods: We retrospectively reviewed the medical files of 60 patients, 30 obese and 30 healthy controls, aged between 11 and 16 years, who applied to the pediatric outpatient clinic. Laboratory tests, hematological parameters, gender, age, and BMI were compared between the groups. Correlations between monocyte/HDL-cholesterol ratio and other laboratory parameters in the obese group were examined. Results: BMI, Alanine aminotransferase (ALT), C-reactive protein (CRP), triglyceride, insulin, and HOMA-IR levels of the obese adolescent group were statistically significantly higher than the control group (p<0.05). There was no statistically significant difference between the obese and control groups in terms of inflammatory hematological ratios (NLR, PLR, MLR, and monocyte/HDL-cholesterol ratio) (p>0.05). There was no statistically significant relationship between monocyte/HDL-cholesterol and other inflammatory hematological rates (p>0.05). There was a positive, moderate (48.6%), and statistically significant relationship between monocyte/HDL-cholesterol and MLR (p<0.05). Conclusions: In our study, the NLR, PLR, MLR, and monocyte/HDL-cholesterol values of the obese adolescent group were similar to the control group. There was correlation between monocyte/HDL-cholesterol and monocyte/lymphocyte values. There was no correlation between other rates (AU)

Introducción: La obesidad es una enfermedad multifactorial cada vez más importante tanto en niños como en adultos. Los niños y adolescentes obesos tienen un mayor riesgo de volverse obesos en la edad adulta, lo que se asocia con un mayor riesgo de mortalidad y morbilidad. Hay inflamación sistémica subclínica en la obesidad. El estudio tuvo como objetivo evaluar los parámetros hematológicos como indicador de inflamación en adolescentes obesos y mostrar la relación de la relación monocitos/colesterol HDL, que tiene un componente lipídico, con otros parámetros hematológicos inflamatorios. Materiales y métodos: Se revisaron retrospectivamente los expedientes médicos de 60 pacientes, 30 obesos y 30 controles sanos, con edades comprendidas entre los 11 y los 16 años, que acudieron a la consulta externa de pediatría. Se compararon las pruebas de laboratorio, los parámetros hematológicos, el sexo, la edad y el IMC entre los grupos. Se examinaron las correlaciones entre la proporción de monocitos/colesterol HDL y otros parámetros de laboratorio en el grupo de obesos. Resultados: Los niveles de IMC, alanina aminotransferasa (ALT), proteína C reactiva (PCR), triglicéridos, insulina y HOMA-IR del grupo de adolescentes obesos fueron estadísticamente significativamente más altos que los del grupo de control (p<0.05). No hubo diferencias estadísticamente significativas entre los grupos de obesidad y de control en términos de proporciones hematológicas inflamatorias (NLR, PLR, MLR y proporción de monocitos/colesterol HDL) (p>0,05). No hubo una relación estadísticamente significativa entre monocitos/colesterol HDL y otras tasas hematológicas inflamatorias (p>0,05). Hubo una relación positiva, moderada (48,6%) y estadísticamente significativa entre monocitos/colesterol HDL y MLR (p <0,05). Conclusiones: En nuestro estudio, los valores de NLR, PLR, MLR y monocitos/colesterol HDL del grupo de adolescentes obesos fueron similares a los del grupo control (AU)

Evaluation of Transfusion-Related Hemodynamic Parameters in Patients with Beta-Thalassemia Major by Ambulatory Blood Pressure Monitoring Method / Evaluación de los parámetros hemodinámicos relacionados con la transfusión en pacientes con beta-talasemia mayor mediante el método de monitorización ambulatoria de la presión arterial

Introduction: There are very few studies on the effects of regular blood transfusions on the hemodynamic organization of patients with Beta-Thalassemia Major (BTM). Ambulatory Blood Pressure Monitoring is method that evaluates fluctuations in day-night periods and life cycle changes. In this study, we aimed to investigate the effects of blood transfusion on hemodynamic parameters by the Ambulatory Blood Pressure Monitoring method on the day of transfusion in patients with a diagnosis of Beta-Thalassemia Major. Material and Methods: This study was conducted in patients who were followed up with a diagnosis of BTM between June 2020 and July 2020. The study consisted of 30 patients. The blood pressure of the patients was measured by auscultation method on the morning of the day when they received routine red blood cell transfusion treatments, and the patients were fitted with an Ambulatory Blood Pressure Monitoring device. With Ambulatory Blood Pressure Monitoring, mean systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure, values were calculated for each patient. Statistical analysis was performed by the IBM SPSS Statistics 21 package program. The significance limit for the p-value was accepted as <0.05. Results: There was a significant difference in mean systolic blood pressure and heart rate values between pre-transfusion, transfusion, and post-transfusion periods. In our study, the rate of white coat hypertension was 8.3%, and the rate of masked hypertension was 4.1%. It was observed that 67% of the patients were non-dippers, and the blood pressure burden of one patient was more than 25%. Conclusions: Measurement of hemodynamic parameters with Ambulatory Blood Pressure Monitoring is the gold standard in terms of detection and follow-up of non-dipper patients, indicating increased cardiovascular risk. In practice, Ambulatory Blood Pressure Monitoring should be used more in the follow-up of chronic patients.(AU)

Introducción: Existen muy pocos estudios sobre los efectos de las transfusiones de sangre periódicas sobre la organización hemodinámica de los pacientes con Beta-Talasemia Mayor (BTM). La monitorización ambulatoria de la presión arterial es un método que evalúa las fluctuaciones en los períodos diurnos y nocturnos y los cambios en el ciclo de vida. En este estudio, nuestro objetivo fue investigar los efectos de la transfusión de sangre sobre los parámetros hemodinámicos mediante el método de Monitoreo Ambulatorio de la Presión Arterial el día de la transfusión en pacientes con diagnóstico de Beta-Talasemia Mayor. Material y métodos: Este estudio se realizó en pacientes que fueron seguidos con un diagnóstico de BTM entre junio de 2020 y julio de 2020. El estudio consistió en 30 pacientes. La presión arterial de los pacientes se midió mediante el método de auscultación en la mañana del día en que recibieron los tratamientos de transfusión de glóbulos rojos de manera rutinaria, y los pacientes fueron equipados con un dispositivo de monitoreo ambulatorio de la presión arterial. Con la monitorización ambulatoria de la presión arterial, se calcularon los valores de la presión arterial sistólica media, la presión arterial diastólica, la frecuencia cardíaca y la presión arterial media de cada paciente. El análisis estadístico se realizó mediante el programa de paquete IBM SPSS Statistics 21. El límite de significación para el valor p se aceptó como <0,05. Resultados: Hubo una diferencia significativa en la presión arterial sistólica media y los valores de frecuencia cardíaca entre los períodos de pretransfusión, transfusión y postransfusión. En nuestro estudio, la tasa de hipertensión de bata blanca fue del 8,3% y la tasa de hipertensión enmascarada fue del 4,1%. Se observó que el 67% de los pacientes eran no dippers y la carga de presión arterial de un paciente era superior al 25%.Conclusiones: La medición de parámetros hemodinámicos con monitorización...(AU)