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Objective: Maternal anthropometry offers a rapid, inexpensive, and non‐invasive method for assessing nutritional status during pregnancy. We aimed to assess the changes in maternal anthropometric measurements in the first month after delivery and to investigate the factors associated with longitudinal changes in maternal postpartum nutritional status. Design: This prospective longitudinal study included 147 mothers who were on the 5th postpartum day applied to outpatient clinics, from January 2018 through January 2020. Each mother completed a structured questionnaire and baseline anthropometric measurements were performed at the postpartum 5th day and re‐evaluated at the end of the first month after delivery. Participants: Mother‐infant pairs (n = 147). Results: At the end of the first postpartum month, maternal body weight (relative change −5.1%, 95% CI: −5.6%;−4.6%), muscle mass ratio (−1.6%, 95% CI: −2.4%;−0.9%) and body fluid ratio (−2.4%, 95% CI: −3.1%;−1.7%) decreased, whereas fat mass ratio increased (10.3%, 95% CI: 9.0%;11.6%).There was a significant association between infants' feeding type and maternal BMI, weight, muscle mass ratio, body fluid ratio, triceps, and biceps skinfold thickness in mothers (p <.05). We also found a significant relationship between maternal smoke exposure and BMI, maternal weight, fat‐mass ratio (p <.05). Conclusions: There are some important alterations in maternal anthropometric parameters during the postpartum period. This study will help further our understanding of the factors influencing changes in maternal body composition after delivery. [ABSTRACT FROM AUTHOR]

Aim: To investigate the carnitine status and the effect of carnitine supplementation on serum lipid profiles in children with hyperlipoproteinaemia, a clinical open trial was conducted at Hacettepe University Ihsan Dogramaci Children's Hospital, Section of Nutrition and Metabolism.Methods: Patients were given carnitine at a dose of 100 mg/kg/d for 12 wk. Blood samples for the determination of lipid profile and carnitine levels and urine samples for carnitine levels were obtained on admission, at week 4 and week 12 of the study period.Results: A total of 41 children were enrolled in the study: 20 patients had type II heterozygotes, eight patients had type II homozygotes, three patients had type III, six patients had type V and four patients had secondary hyperlipidaemias. Serum and urine carnitine levels were within normal limits on admission. No significant correlations were found between serum carnitine levels and serum lipid profiles. Serum HDL and apolipoprotein A-I decreased significantly during the 12 wk of intervention in type II heterozygotes. In type II homozygotes, total cholesterol and LDL levels at weeks 4 and 12 increased significantly compared to initial levels. No significant change was noted for lipid parameters in hyperlipoproteinaemia type V.Conclusion: The results of this trial demonstrated that carnitine supplementation was of no benefit for children with hyperlipidaemias, especially in primary hyperlipoproteinaemia type II heterozygotes, homozygotes and type V. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the effect of interferon-alpha to 2b and octreotide on the treatment of esophagus corrosive burns.Method: The experimental study was performed on 63 rabbits. Burn was obtained by treating a segment, isolated in cervical esophagus, with NAOH. The rabbits were allocated into three groups (control, interferon, and octreotide). On the fourth, eighth, and 20th days, 7 rabbits randomly selected from each group were killed. Comparisons among the groups were made by taking histopathologic findings, stenosis index, and hydroxyproline production into consideration. Cross-tabulation and analysis of variance tests were used for statistical analysis.Results: There were no statistically significant differences among the groups in terms of epithelial changes, extension of inflammation, and severity of fibrosis. In terms of severity of inflammation, there was a statistically significant difference between the control and the other two groups. Also, a significant difference was found between the control group and the other two groups in terms of extension of fibrosis on the 20th day. The difference between the control and the two treatment groups was significant on the eighth day and the 20th day measurements. Comparison of the hydroxyproline values showed a statistically significant difference between the octreotide group and the other two groups on the eighth and 20th days.Conclusion: Histopathologic and biochemical findings indicate that, by hindering fibrosis progress, octreotide (and interferon) might be new and promising alternatives in the treatment of corrosive burns of the esophagus. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to examine the effects of breast-feeding method (on only one or on two sides in a single feeding session) on growth, sleep duration and sucking period, and stool frequency. Methods: Exclusively breast-fed healthy infants, aged 1–6 months, were included in the study during child health follow-up visits. Mothers were given a questionnaire on sleep duration, sucking periods, and stool frequencies of their infants. Results: The height-for-age and weight-for-age z scores were significantly higher in infants breast-fed from one side during a single session than from both sides ( P= 0.002, P < 0.001; respectively). Infants sucking on only one breast in a breast-feeding session defecated significantly less at night ( P= 0.005), their maximum sucking periods at night were shorter ( P= 0.049). Conclusion: Breast-feeding at one side only during a single breast-feeding session increases growth, decreases stool frequency and the maximum sucking period at night and does not influence the overall sleep pattern. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to determine the serum zinc levels on admission and 7–10 days after clinical recovery from acute gastroenteritis of <8 days’ duration. Methods: This prospective study included 82 infants aged 2–24 months who had no associated bacterial infection, chronic disease, prior antibiotic use, moderate or severe malnutrition or dysentery. Forty-one healthy children formed the control group. Results: The mean serum zinc level on admission (Zn1) was 11.85 ± 2.83 μmol/L and at 7–10 days after recovery (Zn2) was 10.92 ± 2.17 μmol/L; mean serum zinc level of the control group was 11.81 ± 3.45 μmol/L. Zn2 was significantly lower than Zn1, but there was no statistical difference between the mean of the control group and Zn1 and Zn2. When dehydrated patients were excluded from the patient group, Zn1 and Zn2 did not differ. Although asymptomatic, 39% of the control group had low zinc. Serum zinc levels were not affected by sex, age, clinical characteristics of the patients or severity of gastroenteritis. Conclusion: Serum zinc levels of the patients admitted with acute gastroenteritis without any other disease and without moderate or severe malnutrition were not affected by disease state. Gastroenteritis did not further decrease serum zinc levels in patients with asymptomatic or subclinical zinc deficiency. [ABSTRACT FROM AUTHOR]

The epidemiology and antibiotic susceptibility of Shigella species changes over time. Updated susceptibility knowledge is necessary for appropriate empirical antibiotic treatment.In this study the clinical characteristics and the antibiotic susceptibility test results of Shigella species isolated from patients admitted to Hacettepe University Ihsan Doğramac Children's Hospital Diarrheal Diseases Training and Treatment Unit between 1995-2002 (n = 218) were evaluated. The results were compared with the results of 1987-1994 from the same center (n = 618).The predominant species was S. sonnei in both periods with increasing prevalence in the later period (64% and 71.5% respectively, P < 0.05). Although the prevalence of bloody diarrhea among Shigella cases did not change between periods, the prevalence of mild to moderate dehydration (11% and 20.6%) increased. Approximately 40% of cases were prescribed antibiotics on the suspicion of shigellosis. When the two periods were compared, Shigella resistance to trimethoprim/sulfamethoxazole increased from 39% to 70% (P < 0.0001), whereas resistance to ampicillin decreased from 41% to 23% (P < 0.0001). However, the resistance of S. flexneri to ampicillin was found to be quite high (72.9%) between 1995-2002. No Shigella species resistant to ciprofloxacin was detected. Multi-drug resistance was present in 52 (24%) of the cases, of which 10 were S. sonnei (6.3%) and 42 S. flexneri (26.4%) (P < 0.0001).The need to treat all Shigella cases in areas where S. sonnei is predominant should be reevaluated, as should the appropriate empirical antibiotic. [ABSTRACT FROM AUTHOR]

Background: Attendance to a child-care facility is known to be associated with increased rate of episodes of infectious diseases in children. This retrospective cohort study investigates the infection episode rate and the effect of total attending period on infection episode rates in a child-care center (Gülveren Child-Care Center, Ankara, Turkey), at a stable environmental condition, over a 7-year follow-up period.Methods: During the study period, 288 children attended the center and enrolled. Sex, total duration of breastfeeding, starting age at the center, total duration of attendance, and the type and frequency of infections diseases were recorded. Episode rates were calculated for each child.Results: The mean starting age at the child care center was 4.1 ± 0.7 years (range: 2.5–5.8 years); the mean total duration of attendance at the center was 20.4 ± 9.9 months. Over the study period, 1000 infection episodes were detected. The general infection episode rate was calculated as 2.04/child per year. In bivariate analysis, children with longer attendance period (≥12 months), and a younger starting age at the center (<4 years of age) had lower‘moderate general infection’ (≥3 episode/child per year) episode rates than those of other groups. In multiple logistic regression analysis, only total attending period in the center was significantly associated with‘moderate’ level general infection episode rate. The presence of asthma slightly increased the lower respiratory tract infections episode rate in bivariate analysis, and was the only significant predictor of LRTI episode rate in multivariate analysis.Conclusions: The results of the present study show that among children attending a single facility, longer periods of attendance at the facility was associated with a decreased risk of general infection episode, regardless of starting age at the center. Additional cohort studies are needed to determine whether this reduction in general infection episode rate extends into school-age years and whether children moving between different centers affects the incidence of infectious episodes. [ABSTRACT FROM AUTHOR]

Objective: Glutamine is an important fuel for rapidly dividing cells such as enterocytes and lymphocytes. Exogenous glutamine supplementation in catabolic states preserves intestinal mucosal structure and function, decreases bacterial translocation, and supports normal immunologic responses. This study was planned to assess the effect of glutamine supplementation on duration and severity of diarrhea and to assess its immunomodulatory effect by measuring serum interleukin-8 (IL-8) and salivary immunoglobulin A (sIgA) in children with acute diarrhea.Methods: In this placebo-controlled, double-blind and randomized trial, 6- to 24-month-old otherwise healthy children admitted to the Diarrheal Diseases Training and Treatment Center with acute diarrhea received either 0.3 g/kg/day of glutamine (n = 63) or placebo (n = 65) for 7 days. Serum IL-8 and sIgA levels were determined on admission and 7 days later. All cases were followed until the diarrheal episode ended. Anthropometric measurements and history of subsequent infectious diseases were monitored monthly for 3 months after treatment.Results: Mean duration of diarrhea in the glutamine treated group was significantly shorter than that of the placebo group (3.40 +/- 1.96 days, 4.57 +/- 2.48 days, respectively; P = 0.004). No differences in serum IL-8 and sIgA were found between groups on admission or 1 week later. During 3 month follow-up, mean weight gain and incidence of infectious diseases were similar in both groups.Conclusion: Duration of diarrhea was shorter in children supplemented with glutamine. The beneficial impact of glutamine supplementation seems to be through effects on gastrointestinal mucosa rather than the host immune response. [ABSTRACT FROM AUTHOR]

Background: Previous studies on the cognitive effects of iron treatment have focused on anemic or non-anemic iron-deficient infants. The effect of iron supplementation on cognitive development among iron-sufficient infants has not been studied. The aim of the present study was to examine the effect of iron supplementation on performance in the Bayley Scales of Infant Development (BSID) and anthropometric measurement in 6-month-old iron-sufficient healthy infants. Methods: Healthy, iron-sufficient infants who were 6 months of age and were attending the Well Baby Clinic were considered for enrollment. Infants were randomly assigned to take ferrous sulfate supplementation (1 mg/kg per day) or no supplementation and were followed for 3 months. Anthropometric measurement, hematologic status and BSID were evaluated on admission and after 3 months. Results: Seven infants in the intervention group and nine in the control group completed the study. No significant differences were observed in anthropometric measurements and complete blood counts between the two groups after the 3 month study period. The mean transferrin saturation (TS) level decreased significantly in the control group during the study period (from 15.3~2.6 to 7.8~5.1%; P=0.0117), but no such reduction was seen in the intervention group. At the end of the study, the TS of the control group was found to be significantly lower than that of the intervention group (7.8~5.1 vs 19.9~7.9%, respectively; P=0.0033). The BSID scores of infants in both groups were within the normal range on admission and at the end of the study period. Conclusions: Short-term iron supplementation did not change developmental test scores despite the hematologic response in iron-sufficient healthy infants. The high prevelance of iron-deficiency anemia and its relationship with adverse developmental outcome suggests that prevention of iron-deficiency anemia with prophylaxis needs to be emphasized, rather than treatment. [ABSTRACT FROM AUTHOR]

Presents a case study of an infant with right-sided Duane retraction syndrome (DRS) that is associated with multiple malformations. Clinical features and manifestations of DRS; Medical history of the patient; Clinical types of DRS.

Objective/hypothesis: The pathogenesis of tympanosclerosis is unclear. The study was performed to investigate the role of nitric oxide, free oxygen radicals, and antioxidants in development of tympanosclerosis in patients with chronic otitis media., Study Design: A prospective study in patients with nasal polyps., Methods: Sixty-five patients who underwent tympanoplasty or tympanoplasty together with mastoidectomy were included in the study. Preoperative venous blood samples were drawn, and serum sodium, potassium, calcium, alkaline phosphatase, inorganic phosphorus, parathormone, and calcitonin levels were measured. The patients who had tympanosclerotic plaques on tympanic membrane or middle ear mucosa or near the ossicular chain or mastoid bone were designated as group 1 (n = 34), and the remaining patients as group 2 (n = 31). Intraoperatively, specimens were obtained from the middle ear mucosa and tympanic membrane to measure nitric oxide and malondialdehyde levels. In addition, plasma malondialdehyde levels and erythrocyte superoxide dismutase and catalase activity were determined., Results: All patients had similar demographic features and serum electrolyte and hormone levels. Nitric oxide and malondialdehyde levels of the specimens obtained from the middle ear mucosa (P =.001) and tympanic membrane (P =.01) and, in parallel to this, the plasma malondialdehyde activity level were higher in group 1 than in group 2. Moreover, group 2 had significantly lower erythrocyte catalase activity levels (P =.001) compared with group 1, whereas such a significant difference was not present for superoxide dismutase activity levels (P >.05)., Conclusion: The study results suggest that nitric oxide, free oxygen radicals, and catalase may have a role in the development of tympanosclerosis in patients with chronic otitis media.

Transient glucose intolerance (TGI) is an important cause of WHO G-ORS (Glucose-Oral Rehydration Solution) treatment failure and hospitalization in dehydrated children during acute diarrhoea. This retrospective case-control study was designed to determine some risk and predictive factors for developing TGI among moderately dehydrated patients with acute diarrhoea while under G-ORS therapy. Among moderately dehydrated patients, files of 22 patients with TGI and 66 other dehydrated patients without intolerance were reviewed. Patients with TGI were younger (9.7+/-10.5 mo and 11.6+/-7.8 mo, respectively, p < 0.05), the median age being 6 mo in the TGI group and 10 mo in non-TGI group. There was no difference between groups for sex, admission season, history of fever or vomiting, frequency of vomiting, presence of blood, mucous or leukocyte in stool, presence of associated disease and duration of diarrhoea on admission. The admission haemoglobin, white blood cell, blood pH, sodium and potassium levels were similar in both groups. The mean serum chloride level (116.8+/-6.9, 109.6+/-7.9 mEq/l, respectively, p<0.05) was higher in the TGI group and the bicarbonate level was lower (12.9+/-3.8, 15.3+/-6.0, respectively, p < 0.05). Stool frequency was also higher in patients with TGI (11.2+/-5.3/24 h, 5.9+/-4.4/24 h, respectively, p < 0.05). No difference was found between the nutritional status of children in both groups. More children were breastfed in the group without TGI (34/56, 61%, 6/18, 33% respectively, p=0.079, OR=0.32, 95% CI [0.09-1.11]). It was concluded that patients with TGI are younger and have high stool frequency. Although statistical significance could not be shown, breastfeeding seems to protect children from TGI, as it protects from diarrhoea.

Following the successful rehydration of two moderately dehydrated patients with transient glucose intolerance (TGI) using rice-oral rehydration solution (R-ORS), R-ORS has been used in Hacettepe University Ihsan Dogramaci Children's Hospital Diarrhea Training and Treatment Unit (DTTU) to rehydrate moderately dehydrated children with TGI. The files of children with moderate dehydration and glucose intolerance admitted to the unit were reviewed retrospectively within two periods according to the availability of R-ORS. The clinical and laboratory findings were analysed where available. Before R-ORS became available (September 1993) 6 patients were admitted, all of whom deteriorated with glucose (G)-ORS treatment in 7.0 +/- 3.8 h and were hospitalized for i.v. fluid treatment. During the second period 22 moderately dehydrated children with TGI were admitted. The clinical and laboratory characteristics on admission of the children in the two periods were not statistically different (p > 0.05). Among the 22 patients admitted during the second period 10 were administered G-ORS in the unit and 12 had already received G-ORS at home. Clinical and laboratory deterioration was observed in these 10 patients while receiving G-ORS in the unit within 6.3 +/- 3.7 h and rehydration was continued with R-ORS. Clinical and laboratory improvement were demonstrated in 8 patients within 18.2 +/- 6.5 h. Overall, 17 patients were rehydrated successfully with R-ORS, with a mean time of 18.0 +/- 7.2 h. Five patients were hospitalized. The overall success rate of R-ORS was 77.3%. R-ORS may be considered as an alternative mode of therapy to i.v. treatment in the rehydration of moderately dehydrated children with TGI.