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Juvenile dermatomyositis (JDM) is an auto-immune disease characterised by muscle weakness and typical skin findings. Although peri-orbital oedema and facial swelling are compatible cutaneous findings in JDM, they are extremely rare. A 7-year-old boy who presented with peri-orbital oedema and facial swelling without muscle weakness is reported. In addition, he had cholestasis and marked cytopenia, which are uncommon in JDM, and malignancy and metabolic disorders were primarily considered in the aetiology. He had no musculoskeletal complaints other than elevated muscle enzymes on presentation but developed muscle weakness during follow-up, and a muscle biopsy was compatible with inflammatory myopathy. He responded favourably to conventional treatment and there were no physical limitations or skin findings by the 14th month of follow-up. Although patients presenting with typical clinical features are easy to diagnose, atypical skin findings are challenging for the clinician. In the presence of atypical skin and clinical findings in addition to muscle enzyme elevation, JDM should be considered in the differential diagnosis. Abbreviations: AHCE: asymptomatic hyper-CKemia; AST: aspartate aminotransferase; C: complement; CK: creatine kinase; IVIG: intravenous immunoglobulin; IIM: idiopathic inflammatory myopathy; JDM: juvenile dermatomyositis; LDH: lactate dehydrogenase; MAA: myositis-associated antibodies; MDA5: melanoma differentiation-associated gene 5; MRC: Medical Research Council; MRI: magnetic resonance imaging; MSA: myositis-specific antibodies; MTX: methotrexate NXP2: nuclear matrix protein 2; STIR: short tau inversion recovery; US: ultrasound. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between the feeding practices of parents of preschool children and the eating behaviors of children. Material and Methods: The parents who had 2 to 6 years of age children without chronic disease and had completed the transition to supplementary foods were included (n=315). Family demographic, socioeconomic information and children's anthropometric measurements were recorded. The parents completed the "Child Feeding Questionnaire (CFQ)", and "Children's Eating Behavior Questionnaire (CEBQ)". Results: The mean age of the children participating were 46±14.63 months and 46.7% (147/315) of the children were girls. As parents' perceived responsibility for feeding increased, the children's food responsiveness tended to decrease. In parents who had concerns about their child's weight, their children's eating behavior was associated with higher food responsiveness and enjoyment of food and lower satiety responsiveness, slowness in eating, and emotional undereating. Conclusion: Parents' healthy eating attitudes can be part of a process that encourages children to model healthy eating behaviors. 'Satiety responsiveness', 'slowness in eating', and 'emotional under-eating behaviors were observed more frequently with the attitude of restriction and pressure for eating. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the results of the intervention with the "Motivational Interview" on changing the smoking behavior of adolescents in the "Adolescent Outpatient Clinic". Material and Methods: Thirty-two adolescents smoking at least three cigarettes per/day for the last three months were included in the study. The adolescents were interviewed twice with a one-week interval and then with two weeks interval. The motivational interview was conducted to help them quit smoking each time they came to interview. The adolescents were called by telephone three months after the last interview and were questioned on their smoking behavior change (how many cigarettes smoke per day). Results: The mean age of the adolescents was 16.4 ± 1.0 (min: 12.0-max: 18.0) years and 47% (n = 15) of them were female. Among adolescents 28% (n = 9) had a chronic disease. According to the statements of the adolescents three months after the last interview, 6.2% (n = 2) of adolescents quit smoking, and 50% (n = 16) decreased the amount of cigartttes smoked. A statistically significant association was found between the rate of quitting or reducing smoking and the frequency of smoking cessation intervention visits (p = 0.016) and the number of cigarettes smoked per day at first admission (p = 0.047). No significant association was found between the smoking reduction rates and the age of adolescents, the age of first experimentation, and the duration of smoking. Smoking reduction rate was found to be higher in patients with a chronic disease, a non-smoker family, female gender and regular attendance to school; but the difference was not statistically significant (p> 0.05). Conclusion: This study demonstrates that smoking intervention in the early period of smoking and the compliance to smoking cessation interventions may change the smoking behavior of adolescents. [ABSTRACT FROM AUTHOR]

Objective: In the adolescence period, suicide attempts by drug overdose is the problem that emergency doctors are often faced with. It is very important to identify risk factors that can be predictive of future suicide attempts. In our study, we evaluated the adolescents who presented to our pediatric department with suicidal drug overdose to assess the risk factors clinically and demographically. Material and Methods: The records of 135 patients (10-18 years of age) who presented to our pediatric emergency department with suicidal drug overdose were evaluated during a one-year period (1.10.2015 and 1.10.2016). Results: We included 135 patients (82.2% female) with an average age of 15.65±1.37 years in the study. Most of the patients were in the middle adolescence (14-16 years) period (69.6%). 17 patients (12.6%) had a prior suicide attempt history. The time between drug overdose and arrival at the pediatric emergency department was 4.2 hours (min. 1 hourmax. 96 hours) on average. 72.6% of the them applied in the first 4 hours. 60 patients had taken multiple drugs. The usage frequency of the drugs (single/multiple) that the patients had taken to commit suicide was analgesics 48.9%, antidepressants 28.9%, antibiotics 20.7%, gastrointestinal drugs 14%, antihypertensive 8.8%, antipsychotics 7.4%, antiepileptics 7.4% and others (antidiabetics, vitamins-minerals, decongestants, muscle relaxants, antihistamines, psychostimulants, antithrombotics, antigut drugs) 14.8%. The reasons for suicide attempts included family related reasons, boy-girl friend separation, exam anxiety, school anxiety and others (loneliness, gender dysphoria). The most frequent psychiatric disorders that had been previously diagnosed were major depressive disorder, conduct disorder and attention deficit hyperactivity disorder. Epilepsy had been diagnosed in 3 patients other than psychiatric disorder. The number of suicide attempts with the drugs started for these diagnoses (n=22, %16.3) was statistically significant (p<0.05). All the patients were hospitalized and observed for at least 24 hours. There was no mortality during or after the suicide attempt. Conclusion: Clinicians working with young people are required to assess the presence of suicidal ideation, suicidal behavior, and other risk factors, and to determine the level of risk. [ABSTRACT FROM AUTHOR]

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