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Background The high prevalence of sleep problems in children and long-term consequences point to the need for early effective interventions, but health-care providers have limited training in pediatric sleep medicine. The aims of this study were therefore to assess the effectiveness of a sleep health-care education program and to develop a Turkish acronym for brief sleep history taking for pediatric primary caregivers in the ambulatory setting. Methods This was a quasi-experimental study. Four centers were randomly selected from eight training and research hospitals as the intervention group. The control group was recruited during training in subjects other than sleep. Education was provided to the intervention group. Knowledge and attitudes were evaluated in the short and long term. Results The intervention and the control groups consisted of 132 and 78 pediatricians, respectively. The intervention group scored significantly higher both in the short and the long term. The Turkish acronym ( UYKU) was reported to be easy to remember and effective in prompting the correct questions to ask about sleep issues. Conclusions The Turkish acronym would be useful in the primary care setting to increase the frequency of screening of sleep problems in children. Although education significantly improved knowledge on sleep issues in children, the percentage of participants who lacked confidence in the management of sleep problems in children was still very high, even in the intervention group. We suggest that a broader educational program, carried out more than once, would be more beneficial. [ABSTRACT FROM AUTHOR]

Introduction The antimicrobial peptides (AMPs) human β-defensins and cathelicidin (LL-37) are key factors in innate and adaptive immune responses of the respiratory tract and play an important role in many respiratory diseases. No data are available in the literature about the levels of these AMPs in paediatric patients with post-infectious bronchiolitis obliterans (BO). This study aimed to determine human β-defensin 2 (hBD2) and LL-37 levels and compare between post-infectious BO patients and the control group. Method The patients diagnosed with post-infectious BO between September 2012 and 2013 and age- and-gender matched healthy controls were enrolled in this multi-center study. Serum hBD2 and LL37 levels were determined with the enzyme-linked immunosorbent assay method. Results Sixty-three post-infectious BO patients and 65 healthy children (median age 73 ± 55 and 78.74 ± 36.32 months, respectively) were enrolled in the study. The mean of hBD2 levels in patients and the control group were 1.06 ± 0.24 and 0.67 ± 0.72 ng/mL, respectively ( P < 0.001). The mean of LL-37 levels in patients and the control group were 72.13 ± 29.06 and 50.10 ± 21.98 ng/mL, respectively ( P < 0.001). No correlation was found between these AMPs levels and chronological age, age at the time of diagnosis, gender, Z-scores of weight and length, hospitalization numbers, the disease history before diagnosis and 25-OH D vitamin levels. Conclusion This is the first study to demonstrate the higher levels of serum hBD2 and LL-37 levels in paediatric post-infectious BO patients. These AMPs may have important roles in the immune systems and pathogenesis of these patients. [ABSTRACT FROM AUTHOR]

Background Persistent or recurrent pneumonia in children can pose a significant challenge to paediatricians and respiratory physicians. Aim The aim of this study is to determine the role of flexible bronchoscopy ( FB) in evaluation of recurrent or persistent pneumonia that remain otherwise unexplained by non-invasive diagnostic tests in children. Methods Retrospective evaluation of patients who underwent FB with an indication of recurrent or persistent pneumonia from 1997 to 2011. Results Among 2600 FB procedures, 434 (17%) were performed with the indication of recurrent or persistent pneumonia. There were 237 (54%) boys. Median age at presentation was 84 months, and median duration of symptoms was 9 months. FB led to specific diagnosis in 33% of the cases. The most common diseases diagnosed by FB were malacia disorders ( n: 32, 7%), aspirated foreign body ( n: 30, 7%), endobronchial tuberculosis ( n: 20, 5%), congenital airway anomalies ( n: 14, 3%), mucus plugs ( n: 14, 3%), pulmonary haemosiderosis ( n: 12, 3%) and middle lobe syndrome ( n: 11, 3%). During FB, only 6% of the patients had minor complications such as transient hypoxia, stridor and tachycardia. Conclusions In our study, FB proved to be a safe and effective tool in evaluation of children with persistent or recurrent pneumonia. FB is indicated for children with recurrent or persistent pneumonia where the underlying diagnosis remains unclear even after non-invasive diagnostic tests. [ABSTRACT FROM AUTHOR]

In this population-based study, we aimed to determine the total sleep duration (TSD), its association with socio-economic status (SES) and behavioural symptoms among schoolchildren. A cross-sectional study was performed among schoolchildren in Istanbul. A structured questionnaire evaluating the sleep schedule variables was filled out by their parents. SES was determined according to the Turkish SES scale. The mean age of 2669 children was 8.2 ± 2.4 years, and 51% of the students were girls. The mean TSD was 10.20 ± 1.04, and the mean bedtime was 21.57 ± 0.56 (both in hours, minutes ± SD). Boys tended to go bed later (p = 0.004) and slept less than girls (p = 0.02). The duration of sleep disruptions increased (p < 0.001), whereas TSD decreased with age (p < 0.001). Multiple linear regression revealed that waking time and TSD decreased significantly (p < 0.05) with higher SES among both girls and boys. Sleep fragmentation was associated with habitual snoring, parasomnias, daytime sleepiness and conduct symptoms. Decreased total sleep duration is more prominent in boys, older children and children among higher socio-economic status. Insufficient sleep attributed to shortened total sleep duration by age and higher socio-economic status might have a negative effect on both sleep hygiene and psychological well-being in schoolchildren. [ABSTRACT FROM AUTHOR]

Behavioral risk factors are associated with sudden infant death syndrome (SIDS). Education about the risk factors of SIDS is important for prevention. Our aim was to determine the knowledge and attitude of parents and health professionals about SIDS. A total of 174 health professionals and 150 mothers were enrolled in this study. Mothers' data were collected by telephone interview and health-care professionals were interviewed by the same investigator. Only 39% of mothers were aware of SIDS. Forty-six percent of the mothers preferred a supine sleeping position for their infant and 16% of the parents were bed-sharing with their infants. Seventy-three percent of health professionals selected side, 17% supine and 10% prone sleeping position as the safest sleeping position. Frequencies for awareness of risk factors were: bed-sharing (75%), soft bedding (70%), pillow use (52%), toys in bed (90%), high room temperature (67%) and smoking (88%). Total knowledge score of health professionals who selected supine sleeping position as the safest was significantly higher ( P < 0.001). Most of the mothers were unaware of SIDS and less than half preferred a supine sleeping position for their infant. Only 72% of health professionals recommended a certain sleeping position during family interviews. Health professionals are more often recommending the side sleeping position or prone. Education of families and health professionals for the risk factors of SIDS may reduce the number of deaths from SIDS in Istanbul. [ABSTRACT FROM AUTHOR]

The article presents a study which compared the respiratory symptoms and the lung function of working children in different occupational groups in Turkey. In the study, chronic cough, wheezing and shortness of breath of 642 respondents were evaluated using univariate and multivariate methods including pulmonary function tests. Researchers identified the smoking, age, gender and work characteristics of such children. Results revealed that the prevalence of respiratory symptoms was higher in the lathe, coiffure and electricity-construction groups.

Objective.— The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren. Study Design.— A cross-sectional study was performed on 2669 schoolchildren via a parental questionnaire. Socioeconomic status was determined according to the Turkish socioeconomic status scale. Results.— The mean age of the students was 8.2 ± 2.4 years. The headache prevalence was 46.2% (95% CI: 44.3-48.1). The prevalence of migraine was 3.4% (95% CI: 2.8-4.1), the prevalence of probable migraine was 8.7% (95% CI: 7.6-9.8), and that of non-migraine headache was 34.1% (95% CI: 32.3-35.9). Multivariate analysis revealed that older age, being a girl, having a family history of headache, and exposure to passive smoking at home were independently associated with headache. There was an inverse association between socioeconomic status and all 3 types of headaches after adjusting for age, sex, family history of headache, and presence of passive smoking. When the group with the lowest socioeconomic status was taken as the reference category, the odds ratios for the highest socioeconomic group were 0.33 (95% CI: 0.16-0.69, P = .003) for the migraine, 0.30 (95% CI: 0.11-0.89, P = .029) for the probable migraine, and 0.34 (95% CI: 0.16-0.72, P = 0.005) for the non-migraine headache. Conclusion.— Headache is more common among children with lower socioeconomic groups. Social causation can play a role in the pathogenesis of headache. [ABSTRACT FROM AUTHOR]

Background: Childhood asthma is reported to be underdiagnosed and undertreated worldwide. The purpose of the present study was to investigate the rate of underdiagnosis and undertreatment among children diagnosed with asthma in a tertiary reference center in Turkey. Methods: A questionnaire survey was carried out among the parents of 1134 patients diagnosed with asthma in a tertiary reference outpatient clinic. Results: Mean age of the patients was 4.9 years (range 1–17 years). Of these children 45.5% had recurrent asthma attacks (average 4.8 attacks per year) and 24.7% had only the symptom of vigorous fits of coughing. Although they had been symptomatic for 29.6 months, only 41.1% were diagnosed as having asthma before admission to the clinic. In this study group 61.3% had received some form of asthma treatment, but only 21.1% of all patients were treated according to the guidelines. The rate of treatment according to guidelines was lower in the children under 6 years of age than older children (18.8 vs 24.2%, respectively, P = 0.02). Conclusions: Underdiagnosis and undertreatment of childhood asthma still seem to be a major problem in the management of childhood asthma, especially in preschool children, even after the recommendations of guidelines. [ABSTRACT FROM AUTHOR]

There is abundant evidence that artificial ventilation can aggravate pre-existing lung disease, which may contribute to morbidity and mortality. This is especially true for patients with air leakages. This case report describes the use of a pumpless extracorporeal lung assist as a rescue therapy to provide time to heal during the mechanical ventilation of a 16-year-old with cystic fibrosis who could not be managed via conventional means. [ABSTRACT FROM AUTHOR]

Reports a thirteen-year-old boy mucoepidermoid cancer located at the left lower lobe orifice that presented with recurrent pneumonia. Details of the medical history of the patient; Incidence of primary lung tumors in children.