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In mild cases, it is difficult to diagnose pancreatic exocrine insufficiency (PEI). There is no gold standard method for the diagnosis of PEI. A reliable method is needed for preliminary diagnosis of PEI. The PEI-TEST was applied to the patients with nonspecific gastrointestinal complaints. Serum amylase, lipase, serum trypsinogen, and fecal elastase 1 (FE-1) were analyzed from each patient. According to the PEI-TEST, PEI was present in 42 (47.7%) and PEI was not present in 46 (52.3%) patients. No significant difference was observed between the 2 groups with regard to age, gender and amylase, lipase, serum trypsinogen, and FE-1. When an FE-1 value of <200 µg/dL was considered as indicating PEI, the sensitivity and specificity of the test were found to be 47.4% and 52.2%, respectively. Although it is promising that PEI-TEST is a validated test in our country and suitable for our society, it is not suitable for pediatric patients. [ABSTRACT FROM AUTHOR]

Aim: The differentiation of inflammatory bowel diseases (IBD) from other gastrointestinal diseases in pediatric patients is highly important and the definitive diagnosis of IBD is established by endoscopic examination. The use of non-invasive methods (clinical symptoms and laboratory tests) allows for the early and accurate referral of patients from first step health centers to advanced health centers. We aimed to investigate the effectiveness of fecal calprotectin (FC) in the differentiation of IBD from other gastrointestinal diseases in children. Materials and Methods: This retrospective study included patients who had undergone FC testing and colonoscopy. The demographic characteristics, alarm symptoms (AS), and abnormal laboratory findings (ALF) were recorded for each patient. A negative calprotectin result was considered to be less than 50 µg/g, and a second cut-off value for FC was accepted as 150 µg/g. Definitive diagnosis was established by colonoscopy in each patient. Results: The study included 88 consecutive patients (mean age, 10.2±6.1 years; 51.1% female). Of these, 20 (22.7%) patients were diagnosed with IBD. No significant difference was found between IBD and non-IBD patients with regard to the presence of AS except for involuntary weight loss (p<0.001). The prevalence of increased C-reactive protein and hypoalbuminemia was significantly higher in the IBD patients (p=0.002 and p=0.026, respectively). FC>50 µg/g [80.0 vs 39.7%, p=0.044, odds ratio (OR): 6.07, 95% confidence interval (CI) 1.83 to 23.42] and >150 µg/g (60.0 vs 16.2%, p=0.002, OR: 7.78, 95% CI 1.83 to 20.14) was significantly higher in the IBD patients compared to the non-IBD patients. AS combined with ALF and FC>150 µg/g had the highest specificity (95.12%). Conclusion: Although primary care clinicians often use AS and laboratory parameters in the differentiation of IBD from non-IBD diseases, FC was found to have a relatively higher diagnostic value. [ABSTRACT FROM AUTHOR]

Objective: Anemia is a common problem in outpatient clinics, and endoscopic interventions are one of the initial steps to rule out the gastrointestinal causes. In this study, we aimed to analyze the diagnostic yield of endoscopic interventions in children with severe anemia. Materials and Methods: The demographic features, laboratory findings, and endoscopic and histopathological findings of 65 children with severe anemia (hemoglobin <7 g/dL) (mean age of 12.1 ± 4.4 years, 73.8% female) who underwent endoscopic interventions were recorded from the files. Patients were divided into 2 groups according to the presence of positive endoscopic findings and/or histopathological examination. Factors that may predict the presence of positive endoscopic findings and/or histopathological examination were analyzed. Results: After a colonoscopy and/or upper gastrointestinal endoscopy, the etiology of anemia was identified in 35 patients, and the major diagnosis of Helicobacter pylori gastritis in 16.9% and gastrointestinal ulcer in 10.8% of the patients was made. No gastrointestinal pathology was detected in 30 patients. The diagnostic yield of endoscopic examination in patients with severe anemia was 53.8% (95% CI: 63.3-67.7). Presence of hypoalbuminemia (P = .021), high erythrocyte sedimentation rate (P = .006), and high C-reactive protein (P = .03) was significantly associated with positive findings in endoscopic interventions. Conclusion: We recommend performing upper gastrointestinal endoscopy and/or colonoscopy in patients with severe anemia associated with gastrointestinal symptoms and using laboratory findings of hypoalbuminemia, high erythrocyte sedimentation rate, and C-reactive protein in order to rule out gastrointestinal pathologies. [ABSTRACT FROM AUTHOR]

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children. [ABSTRACT FROM AUTHOR]