AKUT GASTROENTERİTLE ÇOCUK POLİKLİNİĞİNE BAŞVURAN HASTALARDAKİ ROTAVİRÜS VE ENTERİK ADENOVİRÜS SIKLIĞI Frequency of Rotavirus and Enteric Adenovirus Infection in Children with Acute Gastroenteritis Admitted to Children Outpatient Clinic
ÖZET
Amaç: Çocuklarda akut gastroenterit yüksek mortalite ve morbidite ile seyredebilmektedir. Akut gastroenterit
tanı ve tedavi yaklaşımlarında viral etkenler çoğunlukla göz ardı edilerek endikasyon dışı ampirik
antibiyotik kullanılması çok sık rastlanılan bir durumdur. Bu çalışmada çocuk polikliniğine akut gastroenterit
nedeniyle başvuran hastalardaki rotavirüs ve adenovirüs sıklığının belirlenmesi amaçlanmıştır.
Gereç ve Yöntemler: Ocak 2018-Ocak 2019 tarihleri arasında hastanemize ishal nedeniyle başvuran 518
hasta retrospektif olarak incelendi. Dışkı örneklerinde rotavirus ve adenovirus antijenlerinin varlığı immünokromatografik
yöntemle ROTA/ADENO (Acrobiotech, USA) kiti ile üretici firma önerileri doğrultusunda
kalitatif olarak değerlendirildi.
Bulgular: Çalışmaya 518 ishalli olgu alındı. 49 olguda (% 9.4) rotavirüs antijen pozitif, 5 vakada (% 0.96)
adenovirüs pozitif idi. Mevsimlere göre değerlendirildiğinde; rotavirüs % 18 lik bir oran ile en sık kış ayında
görüldü, adenovirüs ise % 2.5 ile en sık sonbaharda rastlandı. Yaşlara göre bakıldığında ise rotavirüs ve adenovirüs
en sık 6-10 yaş arasında saptandı.
Sonuç: Akut gastroenteritlerin tanı ve tedavisinde özellikle kış aylarında rotavirüs ve adenovirüs etken olarak
düşünülmelidir. Rotavirüs oranının literatürden daha düşük çıkması aşılanma bilincinin artmasına bağlanabilir.
Rutin aşı takvimine girerse bu oranın daha da azalacağını düşünüyoruz.
Anahtar Kelimeler: Adenovirüs; Akut Gastroenterit; Rota virüs
ABSTRACT
Objective: Acute gastroenteritis in children may progress with high mortality and morbidity. It is a common
practice using antibiotics for treatment of diarrhea in children usually without taking into account viral
agents. In this study, we aimed to investigate the frequency of rotavirus and adenovirus antigen positivity in
children with acute gastroenteritis admitted to children outpatient clinic.
Material and Methods: A total of 518 children who applied between January 2018 and January 2019, with
complaints of acute gastroenteritis, were investigated retrospectively. Presence of rotavirus and adenovirus
antigens in stool samples was evaluated qualitatively with the immunochromatographic method, ROTA /
ADENO (Acrobiotech, USA) kit according to the manufacturer's recommendations.
Results: Five-hundred-eighteen diarrhea cases were included in the study. Rotavirus antigen was positive
in 49 cases (9.4 %), adenovirus was positive in 5 cases (0.96 %). When evaluated according to the seasons;
rotavirus was most common in winter, at a rate of 18 %, adenovirus, on the other hand, was most common
in the fall with 2.5 %. According to the ages, rotavirus and adenovirus were most common between the
ages of 6-10.
Conclusion: In the diagnosis and treatment of acute gastroenteritis especially in winter, rotavirus and adenovirus
should be considered as agents. The fact that the rotavirus rate is lower than the literature may be
related to increased awareness of vaccination. We think that this rate will decrease even more if the routine
enters the vaccination schedule.
Keywords: Acute Gastroenteritis; Adenovirus; Rotavirus
Effect of Lumbar Spinal Stenosis on Pain, Daily Activities of Living and Muscular Activity
Objective: The aim of this study was investigate whether or not lumbar spinal stenosis (LSS) had effect onpain, daily living activities and muscular activation.Material and Methods: Individuals diagnosed as lumbar spinal stenosis with average of 55,19 ± 10,41 yearsold was included to the study. Individuals were divided into three groups as mild, moderate and severe bydural pouch magnetic resonance imaging inspection. Resting and activity pain assessment was made withvisual analog scale (VAS), muscular activity of the rectus femoris, biceps femoris, tibialis anterior and medialpart of the gastrocnemius was measured with surface electromyography (sEMG), and daily living activitieswas assessed with Oswestry lower back disability index.Results: Significant difference was found in VAS and ODI values according to the LSS severity (p<0,05). Painin resting and during activities were different from each other (p<0,05). It was found that individuals withsevere LSS had more lower limb muscular activity compared to moderate and mild individuals, and individuals with moderate LSS had more muscular activity compared to the mild ones (p<0,05).Conclusion: It was determined that disability and pain increases as the LSS severity increases. It was observed that more pain occurs while patients are active. It was concluded that early diagnosis of LSS is importantand necessary preventions should be taken to prevent further increase in severity.
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