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Item COVID-19 in pediatric patients undergoing chronic dialysis and kidney transplantation(SPRINGER, 2022-01-01) Canpolat, Nur; Yildirim, Zeynep Yuruk; Yildiz, Nurdan; Tasdemir, Mehmet; Goknar, Nilufer; Evrengul, Havva; Gulmez, Ruveyda; Aksu, Bagdagul; Dursun, Hasan; Ozcelik, Gul; Yavascan, Onder; Cicek, Rumeysa Yasemin; Tulpar, Sebahat; Hacihamdioglu, Duygu Ovunc; Nayir, Ahmet; Alpay, HarikaThe study aims to present the incidence of COVID-19 in pediatric patients undergoing renal replacement therapy (RRT) and to compare the severity and outcomes of the disease between the dialysis and kidney transplant (KTx) groups. This multicenter observational study was conducted between 1 April and 31 December 2020 in Istanbul. Members of the Istanbul branch of the Turkish Pediatric Nephrology Association were asked to report all confirmed cases of COVID-19 who were on RRT, as well as the number of prevalent RRT patients under the age of 20. A total of 46 confirmed cases of COVID-19 were reported from 12 centers, of which 17 were dialysis patients, and 29 were KTx recipients. Thus, the incidence rate of COVID-19 was 9.3\% among dialysis patients and 9.2\% among KTx recipients over a 9-month period in Istanbul. Twelve KTx recipients and three dialysis patients were asymptomatic (p = 0.12). Most of the symptomatic patients in both the dialysis and KTx groups had a mild respiratory illness. Only two patients, one in each group, experienced a severe disease course, and only one hemodialysis patient had a critical illness that required mechanical ventilation. In the entire cohort, one hemodialysis patient with multiple comorbidities died. Conclusion: While most cases are asymptomatic or have a mild disease course, pediatric patients undergoing dialysis and a kidney transplant are at increased risk for COVID-19. What is Known: In adult population, both dialysis patients and kidney transplant recipients are at increased risk for severe illness of COVID-19 and have higher mortality rate. Children with kidney transplantation are not at increased risk for COVID-19 and most have mild disease course. Data on children on dialysis are scarce. What is New: Pediatric patients undergoing dialysis and kidney transplantation have an increased risk for COVID-19. Most patients undergoing renal replacement therapy either on dialysis or transplanted develop asymptomatic or mild COVID-19 disease with a favorable outcome.Item Radiofrequency catheter ablation of left-sided accessory pathways via retrograde aortic approach in children(ELSEVIER SCIENCE BV, 2016-01-01) Ayabakan, Canan; Sahin, Murat; Celiker, AlpayBackground: We aimed to analyze the results of retrograde aortic radiofrequency catheter ablation of left-sided accessory pathways in children. Methods: Between January 2010 and September 2014, 25 children who underwent left-sided accessory pathway ablation with a retrograde aortic approach were evaluated retrospectively. Results: The mean age of the patients was 11.09 +/- 3.71 years. Seventeen patients were male (68\%). The mean procedure and fluoroscopy times were 71.54 +/- 21.05 min and 31.42 +/- 19.57 min, respectively. Radiofrequency energy was delivered with 41.38 +/- 15.32 W at 52.38 +/- 5.45 degrees C. Sixteen patients (64\%) presented with manifest preexcitation and, 9 had concealed accessory pathways. The location of accessory pathway was left lateral in 16 patients, posteroseptal in 5, left anterolateral in 2, and left posterolateral and left posterior in the remaining 2. The acute success rate was 96\%. The patients were followed for a mean of 16.68 +/- 18.01 months. There were 2 recurrences. No major complications were observed in the periprocedural period. One patient had groin hematoma, another one had transient severe headache and vomiting. Trivial mitral regurgitation was noted in a patient, which remained the same throughout follow-up. None of the patients developed new aortic regurgitation, pericardial effusion, or thrombi at the site of ablation. Conclusions: The retrograde aortic approach can be safely employed with a high success rate for ablation of left-sided accessory pathways in children. (C) 2016 Japanese Heart Rhythm Society. Published by Elsevier B.V.Item Tracheostomy in Pediatric Intensive Care Unit: When and Where?(KOWSAR CORP, 2016-01-01) Ertugrul, Ilker; Kesici, Selman; Bayrakci, Benan; Unal, Omer FarukBackground: Tracheostomy was first observed in Egyptian drawings in 3600 BC and performed frequently during the 1800's diphtheria epidemic. Objectives: The aim of this study was to elucidate the indications, complications, mortality rate, and the effect of pediatric tracheostomy on length of PICU or hospital stay. Materials and Methods: Demographic characteristics, diagnosis at admission, duration of ventilation of 152 patients were analyzed retrospectively. Results: The most common tracheostomy indication was prolonged intubation. The mean duration of mechanical ventilation before tracheostomy was 23.8 days. Forty five percent of the tracheostomy procedures were performed at bedside. Neither the place nor the age had any effect on the development of complications (P = 0.701, P = 0.622). The procedure enabled 62\% of the patients to be discharged from hospital. Conclusions: Tracheostomy facilitates discharge and weaning of mechanical ventilation. Although the timing of tracheostomy has to be determined for each individual patient, three weeks of ventilation seems to be a suitable period for tracheostomy. Tracheostomy can be performed at bedside safely but patient selection should be made carefully.