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Competing Interests: The authors declare that they have no conflict of interest.

Competing Interests: The authors declare that they have no conflict of interest.

Acyclovir may cause acute kidney injury (AKI) due to the accumulation of relatively insoluble acyclovir crystals in renal tubules. The aim of this study was to evaluate risk factors associated with acyclovir-related AKI in children. Between January 2010 and December 2019, pediatric recipients of intravenous (IV) acyclovir were evaluated retrospectively. There were a total of 472 patients [249 (52.7%) boys] of which 32 (6.8%) had AKI [15 (46.8%) boys]. Patients with AKI had greater mean age, baseline creatinine level, and duration of treatment compared to patients without AKI (p<0.001). In the AKI group, concomitant nephrotoxic drug use was more frequent (p=0.032), and the percentage of patients treated with 1500 mg/m 2 /day dosage was higher (p<0.001). AKI was diagnosed at a mean of 4.3 ± 2.5 days after acyclovir initiation and creatinine levels returned to normal at a mean of 7.3 ± 3.6 days after AKI diagnosis. Only eight patients (25%) had vomiting which led to suspicion of AKI. Being older than 100.5 months (HR: 4.501, 95% CI: 1.802-11.241; p=0.001), use of 1500 mg/m 2 /day acyclovir (HR: 9.536, 95% CI: 2.157-42.158; p=0.003) and use of concomitant nephrotoxic drugs (HR: 5.043, 95% CI: 2.289-11.109; p<0.001) were the factors that independently increased the likelihood of nephrotoxicity.Conclusion: Most patients were asymptomatic when they were diagnosed with AKI. Clinicians should be aware of AKI risk in pediatric patients with risk factors (age >100.5 months, 1500 mg/m 2 /day dosage, concomitant use of nephrotoxic drugs). Acyclovir dosing should be evaluated in prospective, multicenter studies in order to identify the lowest possible therapeutic doses that do not increase AKI risk. What is Known: • Although acyclovir is mostly well tolerated, nephrotoxicity may be seen due to the accumulation of acyclovir crystals in renal tubules. • Older age, obesity, and concomitant use of other nephrotoxic drugs are reported to be risk factors for acyclovir-induced AKI in children. What is New: • In this study, pediatric patients with acyclovir-induced AKI were older, received treatment longer, received concomitant nephrotoxic drugs more commonly, and had higher acyclovir dosage and baseline creatinine levels compared to those without AKI. • Being older than 100.5 months of age, use of 1500 mg/m 2 /day dosage and use of nephrotoxic drugs concomitantly appear to be the prominent risk factors for AKI development in children treated with acyclovir., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background/aim: The insula has attracted the attention of many neuroimaging studies because of its key role between brain structures. However, the number of studies investigating the effect of sex and laterality on insular volume is insufficient. The aim of this study was to investigate the differences in insular volume between sexes and hemispheres., Materials and Methods: A total of 47 healthy participants [24 males (20.08 ± 1.44 years) and 23 females (19.57 ± 0.90 years)] underwent magnetic resonance imaging (MRI). Imaging was performed using the 3T MRI scanner. The insular volume was measured using the Individual Brain Atlases using Statistical Parametric Mapping (IBASPM); total intracranial, cerebral, grey and white matter volumes were measured using volBrain., Results: The right insular volume was significantly higher than the left insular volume in the participants, and the left cerebral volume was significantly higher than the right cerebral volume (p < 0.05). The total brain, total cerebral, left and right insular, and cerebral volumes were significantly larger in males than in females (p < 0.001). Also, the ratios of the insular volume to total brain and cerebral volume were significantly higher in males than in females (p < 0.05)., Conclusion: This study shows that insular volume differs with laterality and sex. This outcome may be explained by the anatomical relationship between the insula and behavioural functions and emotional reactions and the fact that the right side of the brain is best at expressive and creative tasks., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Objectives : To determine the serotype distribution of pneumococcus causing invasive pneumococcal disease (meningitidis, bacteremia and empyema) in children in Turkey, and to observe potential changes in this distribution in time to guide effective vaccine strategies. Methods : We surveyed S. pneumoniae with conventional bacteriological techniques and with real-time polymerase chain reaction (RT-PCR) in samples of cerebrospinal fluid (CSF), blood and pleural fluid. S. pneumoniae strains were isolated from 33 different hospitals in Turkey, which are giving health services to approximately 60% of the Turkish population. Results : A total of 167 cases were diagnosed with invasive pneumococcal disease between 2015 and 2018. We diagnosed 52 (31.1%) patients with meningitis, 104 (62.2%) patients with bacteremia, and 11 (6.6%) patients with empyema. Thirty-three percent of them were less than 2 years old and 56% less than 5 years old. Overall PCV13 serotypes accounted for 56.2% (94/167). The most common serotypes were 19 F (11.9%), 1 (10.7%) and 3 (10.1%). Conclusions : Besides the increasing frequency of non-vaccine serotypes, vaccine serotypes continue to be a problem for Turkey despite routine and high-rate vaccination with PCV13 and significant reduction reported for the incidence of IPD in young children. Since new candidate pneumococcal conjugate vaccines with more serotype antigens are being developed, continuing IPD surveillance is a significant source of information for decision-making processes on pneumococcal vaccination.

Purpose: The aim of this study is to determine health sciences undergraduate students' perceived meaning of life and coping styles and the correlation between them., Design and Methods: This is a descriptive study. The study sample consisted of 1160 students. Data were collected using a personal information form, the personal meaning profile (PMP), and the ways of coping inventory (WCI)., Findings: Participants had the highest mean scores on PMP relationship and intimacy subscales while they had the highest and lowest mean scores on WCI self-confident coping style and submissive coping style subscales, respectively., Practice Implications: It is thought that the study will guide us in the process of vocational training of students or guidance and counseling services provided to them., (© 2019 Wiley Periodicals, Inc.)

Purpose: This study aimed to determine experiences and needs of Turkish adolescent siblings of children with cancer (SCC) and to identify if there is a country/culture-specific risk factor for these siblings., Design and Method: In this qualitative study hermeneutic phenomenological approach was used. Eighteen eligible siblings were selected purposively from two hospitals in Ankara, Turkey. Interviews were conducted with a semi-structured form. Content and thematic analyses were used to analyze the data., Results: The data revealed three levels of themes. The main theme was based on "I am here, too". From the first moment of diagnosis, siblings need to be visible and noticed by others. They seek ways to make sense of the disease as they experience dramatic changes in all aspects of their lives (high level themes - first encounter with the disease and changes in life). They expect their parents and relatives to support them (expectations) when they turn to various methods to cope with the changes (coping styles)., Conclusions: The lack of protective psychosocial care is a basic risk factor for adolescent SCC in Turkey. Despite its various limitations, the strongest aspect of this study is that it is the first publication that determines the experiences of Turkish SCC in their own words. In addition to supporting recent findings about siblings' experiences, obtaining some country-specific findings is a strength of the present study., Practice Implications: Providing psychosocial risk assessment of the siblings' immediately after diagnosis is necessary. It can be helpful to inform parents about the risks., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This study was conducted to assess the effectiveness of empowerment program on increasing self-esteem, learned resourcefulness, and coping ways in women exposed to domestic violence. This experimental study was conducted between October 2012 and June 2014 in the obstetrics and gynaecology departments of the Giresun Maternity Hospital, and at the Family Counseling Center (FCC) in Turkey. Sixty women who agreed to participate in the study were randomly assigned into two groups. Data were collected by the Coopersmith Self-Esteem Inventory (SEI), The Rosenbaum's Learned Resourcefulness Scale (RLRS), and the Ways of Coping Inventory (WCI). The assessment of the women before and after the empowerment program showed that women in the intervention group showed significant improvements in the SEI, RLRS, and WCI scores compared with controls. These results suggest that the empowerment program is an effective practice for increasing the levels of self-esteem, learned resourcefulness, and coping ways of women exposed to domestic violence.

Objective: Leishmaniasis is an infectious disease that is caused by a protozoan parasite of the Leishmania genus and that occurs worldwide. Leishmaniasis is endemic in southeastern Turkey and the neighboring Middle Eastern countries. The purpose of this study was to describe the clinical characteristics of patients admitted to our hospital with a diagnosis of cutaneous leishmaniasis (CL)., Methods: A total of 16 CL patients [11 (69%) boys and five (31%) girls] were admitted between January 2014 and December 2015. The data of the patients were retrospectively recorded from their medical records., Results: Their mean age was 74.3±32.3 months (range: 1-10.5 years). Double lesions were most commonly seen in eight (50%) patients. The face and neck was the most commonly involved site (87.5% of the patients). Skin smears for a parasitological examination were positive in nine (56%) patients. Two patients (12.5%) with limb lesions were treated with intralesional meglumine antimoniate. Fourteen patients were treated with systemic agents., Conclusion: We felt that the increase in human movement that include travels and forced migration due to the war might make it possible for CL to appear in non-endemic provinces such as Ankara. In particular, in patients with painless cutaneous lesion(s) who came from endemic areas such as Syria, CL should be kept in mind by the clinicians that residing in even non-endemic areas .

Background: Bloodstream infections (BSIs) caused by Gram-negative (GN) bacteria cause significant morbidity and mortality. There is a worldwide increase in the reported incidence of resistant microorganisms; therefore, surveillance programs are important to define resistance patterns of GN microorganisms causing BSIs. The objective of this study was to describe the clinical and microbiological features of resistant GN BSIs in a tertiary pediatric hospital in Turkey., Methods: Patients between 1 month and 18 years of age hospitalized between January 2005 and December 2012 were included in this study. The presence of ESBL and AmpC type beta-lactamase activity were evaluated using the Clinical and Laboratory Standards Institute (CLSI) disk diffusion and double-disk synergy tests., Results: A total of 209 resistant GN bacterial BSI episodes were identified in 192 patients. Of 192 children, 133 (69.2%) were aged ≤48 months of age. Sixty-six (31.6%) of the BSIs were considered community-acquired and 143 (68.4%) were hospital-acquired infections. The most common isolates were non-fermenting GN bacteria (n=117, 55.9%). The major causative pathogens were Pseudomonas spp. in non-fermenting GN bacteria. The resistance rates to imipenem for Pseudomonas spp. and Acinetobacter spp. were 40.5% and 41.6%, respectively. The most common isolates in fatal patients were Pseudomonas spp. followed by Escherichia coli. The overall 28-day mortality rate was 16.3%., Conclusions: Although our study was performed at a single center and represents a local population, based on this study, it is concluded that surveillance programs and studies of novel antibiotics for resistant GN bacteria focusing on pediatric patients are required., (Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.)

This study was planned to determine internalized stigma of patients who were monitored in the psychiatry clinics due to mental problems. It was determined that there was significant difference between the patients' mean internalized stigma total scores between subscale scores and their gender, job, the place that the patient was raised in, educational status, working status, income level, the period spent after the diagnosis, hospitalization status, the hospital monitoring the patient and the diagnosis. It is suggested that counseling services should be planned in order to identify negative impact of the factors that influence coping with internalized stigma.

Background: In order to provide optimal professional care to patients, nurses must possess a positive self-image and professional identity. High interpersonal sensitivity, coping problems and dysfunctional automatic thoughts can prevent nursing students to be self-confident and successful nurses. Helping nursing students experiencing interpersonal sensitivity problems via cognitive-behavioral counseling strategies can contribute to shape good nurses., Objectives: This study aims to evaluate interpersonal sensitivity, ways of coping and automatic thoughts of nursing students before and after a cognitive behavioral group counseling program., Design: An intervention study with 43 nursing students. Measurements were done before the counseling program, at the end of the program and 4.5months after the program., Settings: The students were chosen from a faculty of nursing in Turkey., Participants: 43 second and third year nursing students who were experiencing interpersonal sensitivity problems constituted the sample., Methods: Brief Symptom Inventory, Ways of Coping Inventory and Automatic Thoughts Questionnaire were used for data collection., Results: The students' scores of "interpersonal sensitivity", "hopeless" and "submissive" copings and "automatic thoughts" were significantly lower at the end of and 4.5months after the program than the scores before the program (Interpersonal sensitivity F=52.903, p=0.001; hopeless approach F=19.213, p=0.001; submissive approach F=4.326, p=0.016; automatic thoughts F=45.471, p=0.001). Scores of "self-confident", "optimistic" and "seeking social support" copings were higher at the end of and 4.5months after the program than the scores before the program (Self confident F=11.640, p=0.001; optimistic F=10.860, p=0.001; seeking social support F=10.411, p=0.001)., Conclusions: This program helped the students to have better results at interpersonal sensitivity, ways of coping and automatic thoughts at the end of and 4.5 months after the program. We have reached the aim of the study. We suggest that such counseling programs should be regular and integrated into the services provided for students., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Hydatid cyst is a zoonotic disease and endemic in Turkey. The disease can involve any organ. The most common involved organ is lung in childhood. Hydatid cyst of lung may be asymptomatic or may be sometimes ruptured or infected. Secondary bacterial infections associated with the hydatid cyst are well known. A previously not reported pediatric case of hydatid cyst with Mycoplasma pneumoniae pneumonia is described in this report. It is emphasized that M. pneumoniae should be kept in mind as a cause of infected hydatid cyst which is unresponsive to beta-laktam antibiotics.

The research was carried out as a pre-test, post-test patterned intervention with one group in order to evaluate the psychoeducation given to older people at nursing homes for a healthy lifestyle and developing life satisfaction. The research was done with 21 female and 21 male older people staying at the state-owned Seyran Bağlari Nursing Home/Elderly Caring Rehabilitation Center and the Ümitköy Nursing Home. In the psychoeducation program, each session was conducted for a duration of 60-90 min in the nursing homes' education classrooms. After the psychoeducation program, the life satisfaction index, the health promotion lifestyle profile total, and the subscale (nutrition, health responsibility, self realization, stress management, interpersonal support, and exercise) mean scores, significantly increased statistically. It is suggested that the nursing homes' health workers, and especially nurses who work full-time, should promote such psychoeducation.