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Background: Tuberous sclerosis (TS) is an autosomal dominant and hereditary disorder. Cardiac rhabdomyoma and arrhythmias are the most deleterious risk factors linked to TS. Although arrhythmias in pediatric patients with TS who have cardiac rhabdomyoma have been frequently reported, arrhythmia in patients who have TS without rhabdomyoma is rarely reported in the literature. The study aimed to assess the susceptibility of pediatric patients who have TS without cardiac rhabdomyoma to cardiac arrhythmia using electrocardiographic (ECG) markers. Methods: This prospective study included 10 patients who had TS without cardiac rhabdomyoma. The control group was made up of 30 healthy children of the same age and sex as the patient group. P wave, P wave dispersion, QT dispersion, QTc dispersion, TP-e interval, and TP-e interval dispersion were calculated on 12-lead surface ECGs for each patient in both groups and compared. Results: P wave, P wave dispersion, QT dispersion, and QTc dispersion were found to be significantly higher in the patient group (P

Background: To evaluate the short-term effectiveness of reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol in children diagnosed with postural orthostatic tachycardia syndrome (POTS) in head-up tilt testing (HUTT).Methods: Children were admitted with symptoms of orthostatic intolerance (OI) occurring in a standing position and disappearing in the supine position. Patients with heart rate increments of >= 40 bpm and symptoms of OI constituted the pediatric POTS group in HUTT. A total of 70 pediatric patients with POTS were included in the study. POTS patients were divided into two groups based on whether they were prescribed reduced-osmolarity ORS and propranolol or not. The study group comprised patients on a regimen of reduced-osmolarity ORS and propranolol (n = 34), while the control group comprised patients who were not prescribed any medication (n = 36). The frequency of symptoms and standardized symptom scores were analyzed before and after 3 months of treatment in both groups.Results: The post-treatment frequency of syncopal attacks was significantly reduced in both groups (P < 0.01 for both groups), but the post-treatment standardized symptom scores were significantly reduced in the pediatric study group compared with the control group (P < 0.01).Conclusion: The frequency of syncopal attacks was significantly reduced and the symptom scores for OI were improved in the study group. The improvement in OI symptom scores was better in the treatment group than in the control group. The control group symptoms persisted and caused extreme difficulty in their daily activities. In view of its clinical efficacy, we strongly advocate the use of combined treatment of reduced-osmolarity ORS and low-dose propranolol in pediatric patients with POTS. (C) 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.

Purpose We aimed to evaluate the autonomic nervous system activity in children with overactive bladder (OAB) syndrome. Methods Included in the study were 40 children with overactive bladder and 28 healthy controls. Autonomic tests were performed on all participants, including heart rate interval variation (RRIV), heart rate response to valsalva maneuver, and sympathetic skin response (SSR). Results Mean valsalva rates in the overactive bladder and control groups were 1.53 ± 0.29 and 1.30 ± 0.18, respectively, a statistically significant difference (P 0.05). Conclusions This study demonstrated a parasympathetic hyperactivity in children with OAB, results suggesting a dysfunction in their autonomic nervous systems. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.

Complete colonic obstruction in children may occur secondary to congenital, and acquired factors related to the gastrointestinal system. Herein, we report an extraordinary presentation of complete colonic obstruction due to extensive urinary retention in a 3-year-old boy. The possible underlying mechanism was detected as urinary infection in a child with horseshoe kidney. The treatment of the bladder symptoms and urinary infection relieved the obstruction of the colon. To our knowledge, especially in children, colonic obstruction due to urinary retention has not been reported in the literature.

Background: The aim of this study was to determine if the skin temperature of febrile children is affected by the child's exposure to cold outdoor temperatures immediately prior to the taking of that temperature. Methods: A total of 150 febrile and non-febrile children (aged 3-10 years) who had walked to the hospital's pediatric emergency department and were thus exposed to outside cold weather were enrolled in the study. Using infrared thermometry, forehead and chest skin temperatures were simultaneously measured every 2 min during the first 14 min after presentation. Temperatures were recorded and differences between the two measurements were calculated. Results: By the fifth evaluation (10 min from the first reading), skin temperatures from forehead and chest had equalized. Conclusion: Determination of fever from the body parts that had been exposed to cold environmental conditions may cause contradictory results if taken while the child is still chilled from exposure to the cold. For accuracy, children should be acclimated to the indoor temperature before taking body temperature readings. Acclimation takes at least 10 min after coming in from cold weather outside.

Amaç: Anne sütü ve mama ile beslenmenin plazma toplam antioksidan kapasiteye etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Anne sütü ya da mama ile beslenen üç ile altı ay arası 34 süt çocuğunda plazma toplam antioksidan ve oksidan seviye ölçülerek oksidatif stres indeksi hesaplandı Çalışma için etik kurulundan onay 14 10 2009 10 7 alınmıştır. Bulgular: Anne sütü ile beslenen grup ile mama ile beslenen grup arasında cinsiyet ve yaş ile toplam antioksidan ve oksidan seviye değerleri arasında anlamlı bir ilişki bulunamadı Anne sütü alan grupta toplam antioksidan seviye değerleri mama alan gruba göre anlamlı yüksek bulundu p=0 004 Anne sütü alan grupta toplam oksidan seviye değerleri mama alan gruba gruba göre düşük bulundu p=0 019 Anne sütü alan grupta oksidatif stres indeksi değerleri mama alan gruba göre düşük bulundu p=0 006.Çıkarımlar: Altı aydan küçük yaş grubunda anne sütü ile beslenme mama ile beslenmeye göre daha iyi bir antioksidan savunma sağlar., Aim: We aimed to evaluate the effect of breast milk and formula on the total antioxidant capacity of the plasma Material and Method: The oxidative stress index was calculated by measuring plasma total antioxidant level and total oxidant level in 35 infants between the ages of 3 and 6 months The study approved by the ethics committe 14 10 2009 10 7 Results: No significant differences were observed between the two groups in respect of age gender plasma total antioxidant status and total oxidant status Plasma total antioxidant levels were higher in the breast fed group than the formula fed group p=0 004 Plasma total antioxidant status was lower in the breast fed group compared to the formula fed infants p=0 019 The oxidative stress index values of the breast fed group were lower than formula fed infants p=0 006 Conclusions: Breast milk provides better antioxidant defence than does formula in infants before six months of age Turk Arch Ped 2012; 47: 95 8

Akut poststreptokoksik glomerulonefrit cocuklardaki akut hipertansiyonun en sik nedenlerinden biridir. Reverzibl posteriyor ensefalopati sendromu PRES , siklikla bilinen hipertansiyon veya immunsupresif ilac kullanimi durumlarinda ortaya cikan bir klinik-radyolojik tablodur. PRES’in karakteristik semptomlari bas agrisi, kusma, gormede bozukluklar, bilinc degisiklikleri ve nobetlerdir. Norolojik sistem goruntulemelerinde en sik gorulen anormallik, beyin hemisferlerininin arka bolgelerinde, ozellikle pariyetooksipital bolgede, ak ve gri maddeyi tutan bilateral odemdir. Burada, akut bas agrisi, bilinc degisikligi, nobet ile basvuran ve APSGN’ye bagli PRES tanisi alan 11 yasinda bir erkek hastayi sunduk.

WOS: 000351515300008 PubMed ID: 25233986 Obesity is a multifactorial disorder resulting from the interaction between genetic, psychological, physical, environmental, and socioeconomic factors. SIRT1 gene has important effects on the regulation of adiponectin, caloric restriction, insulin sensitivity, coronary atherosclerosis, and cardiovascular diseases. The aim of this study was to investigate the association between childhood obesity and SIRT1 gene polymorphisms regarding rs7895833 A > G in the promoter region, rs7069102 C > G in intron 4, and rs2273773 C > T in exon 5 using PCR-CTPP method in 120 obese and 120 normal weight children. In this study, BMI, systolic and diastolic blood pressure, LDL cholesterol, triglyceride, and insulin levels were significantly higher and HDL-cholesterol levels were significantly lower in obese children compared to normal weight children. For rs7895833 A > G, the rate of having AG genotype and G allele was significantly higher in obese children compared to non-obese group (p < 0.001). The risk for obesity was increased by 1.9 times in G allele carriers; therefore, A allele may be protective against obesity. Both study groups had CT heterozygote genotype for rs2273773 C > T. There was no significant difference for rs7069102 C > G gene polymorphism between groups. Conclusion: This is the first study reporting an association between SIRT1 gene polymorphisms and obesity in children. University Research Council, Bezmialem Vakif University [BAP: 9.2012/15] This study was supported by grants from the University Research Council, Bezmialem Vakif University (BAP: 9.2012/15). The authors would like to thank Assoc. Prof. Dr. Arzu Ergen for her help in this study.

WOS: 000352138500020 PubMed ID: 25785999 Aging is defined as the accumulation of progressive organ dysfunction. Controlling the rate of aging by clarifying the complex pathways has a significant clinical importance. Nowadays, sirtuins have become famous molecules for slowing aging and decreasing age-related disorders. In the present study, we analyzed the SIRT1 gene polymorphisms (rs7895833 A>G, rs7069102 C>G and rs2273773 C>T) and its relation with levels of SIRT1, eNOS, PON-1, cholesterol, TAS, TOS, and OSI to demonstrate the association between genetic variation in SIRT1 and phenotype at different ages in humans. We observed a significant increase in the SIRT1 level in older people and found a significant positive correlation between SIRT1 level and age in the overall studied population. The oldest people carrying AG genotypes for rs7895833 have the highest SIRT1 level suggesting an association between rs7895833 SNP and lifespan longevity. Older people have lower PON-1 levels than those of adults and children which may explain the high levels of SIRT1 protein as a compensatory mechanism for oxidative stress in the elderly. The eNOS protein level was significantly decreased in older people as compared to adults. There was no significant difference in the eNOS level between older people and children. The current study is the first to demonstrate age-related changes in SIRT1 levels in humans and it is important for a much better molecular understanding of the role of the longevity gene SIRT1 and its protein product in aging. It is also the first study presenting the association between SIRT1 expression in older people and rs7895833 in SIRT1 gene. University Research Council, Bezmialem Vakif University [BAP: 6.2013/21] This study was supported partially by a grant from the University Research Council, Bezmialem Vakif University (BAP: 6.2013/21) and partially by Ulkan Kilic, PhD, PhD. University Research Council, Bezmialem Vakif University had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript; however, Ulkan Kilic, PhD, PhD had a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Factitious disorder is characterized by deliberate production or imitation of physical or psychological symptoms in order to adopt the sick role. The disorder can be seen as factitious bleeding. Factitious bleeding is a rare disorder in pediatric population. The concomitant appearance of hemoptysis and hematuria in the same patient has not been previously reported. In this case report, we present a pediatric case of factitious disorder with both hemoptysis and hematuria.

Background Oxidative stress may play a role in the pathophysiology of several diseases including allergic rhinitis (AR). In children with AR an antioxidant enzyme paraoxonase (PON1) has not been previously investigated. The aim of this study was to investigate plasma PON1 activity and plasma total oxidant status (TOS), which are in the form of plasma reactive oxidants, and their association with severity of disease in house-mite–sensitive children with AR. Methods This study included 66 children with persistent AR and 40 healthy controls aged between 7 and 12 years old. Plasma PON1, TOS, and total serum immunoglobulin E (IgE) were measured. The nasal symptom scores and body mass index were evaluated at the time of blood collection. Results Mean serum PON1 levels were significantly lower and, TOS levels were higher in the patient group than in the control group (p ≤ 0.001 and p ≤ 0.002, respectively). A significant negative correlation was observed between serum levels of PON1 and nasal symptom scores. However, serum levels of TOS were correlated with nasal symptom scores positively. There were no correlations between levels of total IgE and levels of PON1 and TOS levels. Conclusion Plasma PON1 and TOS levels may serve as predictors of disease severity in children with AR and both of them appear to be attractive candidates for modulating inflammation in AR.

Objective: The purpose of this study was to investigate autonomic nervous system dysfunction by measuring pupil sizes in pediatric patients with allergic rhinitis. Subjects and Methods: The study group consisted of 60 children (28 girls and 32 boys) who were age and gender matched with the control group, which also consisted of 60 children (26 girls and 34 boys). The diagnosis of allergic rhinitis was based on the history, physical examination and skin prick test performed by an allergologist. Pupil diameter measurements were performed using the pupillometer incorporated in the NİDEK OPD-Scan. Results: In the allergic rhinitis group, mean photopic and mesopic pupil diameters were 3.52 ± 0.07 and 5.98 ± 0.21, respectively, while in the control group, corresponding measurements were 4.03 ± 0.18 and 6.55 ± 0.16. There was a significant difference for photopic and mesopic pupil diameter between the groups (p < 0.001). Conclusion: This study showed that the pupil size in response to a light stimulus in children with allergic rhinitis was smaller than that of the control group and may indicate parasympathetic hyperactivity and sympathetic hypoactivity.

Objective: Oxidative stress has been shown to contribute to the pathogenesis of acute and chronic lung inflammatory diseases. This article aimed to evaluate the oxidant/antioxidant status of children with acute bronchiolitis through the measurement of plasma total antioxidant capacity, total oxidant status, and oxidative stress index. Methods: Children with acute bronchiolitis admitted to the pediatric emergency department of a university hospital between January and April of 2012 were compared with age-matched healthy controls. Patients with acute bronchiolitis were classified as mild and moderate bronchiolitis. Oxidative and antioxidative status were assessed by measurement of plasma total antioxidant capacity, total oxidant status, and oxidative stress index. Results: Thirty-one children with acute bronchiolitis aged between 3 months and 2 years, and 39 healthy children were included. Total oxidative status (TOS) was higher in patients with acute bronchiolitis than the control group (5.16 ± 1.99 μmol H2O2 versus 3.78 ± 1.78 μmol H2O2 [p = 0.004]). Total antioxidant capacity (TAC) was lower in children with bronchiolitis than the control group (2.51 ± 0.37 μmol Trolox eqv/L versus 2.75 ± 0.39 μmol Trolox eqv/L [p = 0.013]). Patients with moderate bronchiolitis presented higher TOS levels than those with mild bronchiolitis and the control group (p = 0.03, p

Objectives. The aim of the study is to compare the clinical effectiveness of the probiotics—Saccharomyces boulardiiandBifidobacterium lactis—in children who had been diagnosed with rotavirus gastroenteritis.Materials and methods. Seventy five patients aged between 5 months–5 years diagnosed as rotavirus gastroenteritis were included in the study. The patients diagnosed as rotavirus gastroenteritis by latex agglutination test in stool were divided into 3 groups of twenty-five patients each: First group was given oral rehydration therapy and rapid refeeding with a normal diet withSaccharomyces boulardii(spp. I-745), second group was given oral rehydration therapy and rapid refeeding with a normal diet withBifidobacterium lactis(spp. B94, culture number:) and third group received only oral rehydration therapy and rapid refeeding with a normal diet.Results. The duration of diarrhea was shorter in the group given oral rehydration therapy and rapid refeeding with a normal diet withBifidobacterium lactisandSaccharomyces boulardiithan the group given only oral rehydration therapy and rapid refeeding with a normal diet.Conclusion.Bifidobacterium lactishas a complemental role in the treatment of rotavirus gatroenteritis and other probiotics may also have a beneficial effect in rotavirus gastroenteritis compared with the therapy included only oral rehydration therapy and rapid refeeding with a normal diet.

Aims: The objective of this study is to determine the effects of the long-term treatment with inhaled fluticasone propionate on osteocalcin, cortisol levels, and bone mineral status in children with asthma. Methods: This cross-sectional study examined 230 prepubertal children with asthma (aged 6–11) who had intermittently used inhaled fluticasone propionate for at least 5 years at a mean daily dose of 200 µg (range: 200–350 µg). Serum osteocalcin, cortisol, and bone mineral density (BMD) of the lumbar spine were obtained from each participant. The control group consisted of gender- and age-matched children (n = 170) who were newly diagnosed with asthma and who were not being treated with corticosteroid. Results: The average age (±SEM) was 8.9 ± 0.7 years, their mean (±SEM) daily steroid dose was 180.3 ± 55.0 µg, with 236.5 ± 17.2 g total steroid use during treatment. Between the study and the control groups, no significant differences were observed in cortisol, osteocalcin levels, and BMD (p > 0.05). Conclusion: Long-term treatment with inhaled fluticasone propionate (100 µg twice daily) revealed no negative effects on serum osteocalcin, cortisol levels, and BMD in children with asthma.

Aims The primary aim of the objective of the study was to determine the effects of long-term treatment with the recommended dose of inhaled fluticasone propionate spray usage on bone mineral status in children with asthma. Methods This cross-sectional, case–control study was of 270 pre-pubertal children with asthma, who had used inhaled fluticasone propionate at a mean daily dose of 200 μg (range: 200–350 μg) for at least 5 years. The bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry (DEXA). The results were compared to untreated controls (n = 200), who were newly diagnosed children with asthma without any corticosteroid treatment. Results The 270 study patients (175 males) were aged between 6 and 13 years. The average age (±SEM) was 9.2 ± 0.6 years, and the mean (±SEM) steroid dosage used was 183.3 ± 57.0 μg daily, with 236.5 ± 17.2 g total steroid use during treatment. Between the study and the control groups, no significant difference was observed in BMD (p > 0.05). Conclusion The findings suggest that long-term periodical treatment for 5 years with inhaled fluticasone propionate, 100 μg twice daily, in children with asthma revealed no negative effect on bone mineral density by using DEXA.

Background: This study aims to evaluate the children with chronic cough and to analyze their etiological factors according to the age groups. Method: Five hundred sixty-three children with chronic cough were included. The last diagnosis were established and were also emphasized according to the age groups. Results: The mean age was 5.4 ± 3.8 years (2-months–17-years) and 52 % of them were male. The most common final diagnosis from all the participants were: asthma (24.9 %), asthma-like symptoms (19 %), protracted bacterial bronchitis (PBB) (11.9 %), and upper airway cough syndrome (9.1 %). However, psychogenic cough was the second most common diagnosis in the subjects over 6 years of age. Conclusion: Asthma and asthma-like symptoms were the most common diagnosis in children. Different age groups in children may have a different order of frequencies. Psychogenic cough should be thought of in the common causes especially in older children.