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Introduction: Indirect hyperbilirubinemia is an important problem in newborns and phototherapy has an important role in treatment. The aim of this study is to evaluate the effects of phototherapy on hematological parameters in newborns with indirect hyperbilirubinemia. Method: In the last three months, 60 newborns (term = 30 and preterm = 30) diagnosed and treated for indirect hyperbilirubinemia were included in this study. Results: Twelve of the neonatal terms (40%) had either Rh incompatibility (n = 3) or ABO incompatibility (n = 9), 10 of the preterm newborns (33%) had either Rh incompatibility (n = 3) or ABO incompatibility (n = 7). The median durations of phototherapy of term and preterm newborns were 24 (range, 6-40) and 11 hours (range, 4-36), respectively. After phototherapy, it was found that the counts of WBC and RBC, Hb, MCV and RDW values of term newborns decreased statistically (p values were .0187, .0007, 0001, .0036 and

Amaç: Bu çalışmanın amacı hemanjiyom tanısı alan çocuklarda demografik ve klinik özellikleri ile tedavileri ve tedavi sonuçlarının incelenmesidir. Hastalar ve Yöntemler: Ekim 2017- Eylül 2019 tarihleri arasında hemanjiyom tanısı alan 100 çocuk hastanın dosyası geriye dönük olarak incelendi. Hastaların demografik ve klinik özellikleri, tedavi yaklaşımları ve sonuçları not edildi. Bulgular: Çalışmaya dâhil edilen 100 hastanın 66’sı (%66) kız, 34’ü (%34) erkekti. Hastaların yaş gruplarına göre, 0-3 ay, 3-6 ay, 6-12 ay, 12-24 ay ve >24 ay yaş gruplarında sırasıyla 35, 28, 23, 8 ve 6 hasta vardı. Atmış bir hastada (%61), hemanjiyom baş-boyun bölgesinde yerleşimli iken, baş-boyun dışı yerleşim 39 (%39) hastada saptandı. Tedavi yaklaşımları 71 hastada oral propranolol, 21 hastada topikal timolol damla ve 8 hastada oral propranolol + oral metilprednisolon idi. Oral propranolol ile tedavi edilen 37 hastada (%52), topikal timolol damla ile tedavi edilen 7 hastada (%33,3) ve oral propranolol + oral metilprednisolon ile tedavi edilen üç hastada (37,5) yanıt alındı. Stabil hastalık, oral propranolol alan hastaların 13'ünde (%45,1), topikal timolol damla uygulanan hastaların 13'ünde (%61,9) ve oral propranolol + oral kortikosteroid alan hastaların dördünde (%50) saptandı. Sonuç: çocuklarda, hemanjiyom tedavisinde özellikle oral propranolol tedavisinin etkili ve güvenilir bir tedavi yöntemi olduğu gözlemlenmiştir.

The aim is to determine the oxidative status of children with febrile neutropenia (FEN). Blood samples were collected to determine the total antioxidant capacity (TAC) and total oxidative status (TOS) of healthy children (once) and children with FEN after 0, 48, and 96 hours. Eighteen patients with FEN were evaluated. The baseline TAC level of patients was significantly higher than that of the controls (P0.0001). The TAC levels of patients with FEN with and without antibiotic modification were higher than those of the controls (P=0.002 and 0.02, respectively). The TAC levels of the patients with FEN with antibiotic modification were lower than those of the patients without antibiotic modification (P=0.0224). The oxidative stress index (OSI), calculated TOS/TAS, value of the children with FEN was lower than that of the controls (P0.0001). The OSI values of the patients with FEN with and without antibiotic modification were lower than those of the control group (P=0.001 and0.0001, respectively). The TAC values of the patients with antibiotic modification were higher than those of the patients without antibiotic modification (P=0.02). In conclusion, the oxidative status of the children with FEN was affected, and it can give information about the follow-up of FEN.

Amaç: Bu çalışmanın amacı, beyin sapı tümör tanısı alan ve tedavi edilen hastalarımızın klinik bulguları, tedavi yaklaşımları ve sonuçlarını değerlendirmektir. Gereç ve Yöntem: Kliniğimizde, 2006 ile 2019 yılları arasında beyin sapı tümörü tanısı alan ve tedavi alan hastaların onkoloji dosyaları geriye yönelik olarak incelendi. Bulgular: Beyin sapı tümör tanısı almış 20 hasta çalışmaya dâhil edildi. Hastaların yaşı 2 ile 16 yıl arasında değişiyordu (median, 6,5 yıl). Cinsiyet dağılımı, 14’ü erkek (%70), 6’sı ise kızdı (%30). En sık başvuru şikâyetleri, yürüme bozukluğu (%60), baş ağrısı (%45) ve gözde kayma (%40) idi. En sık fizik muayene bulguları ise ataksi (%55) ve VI. Kranial sinir felci ( %55) idi. Tümör yerleşimleri, pons (%90), bulbus (%5) ve medulla (%5) idi. Dört hastaya parsiyel kitle eksizyonu yapılabilirken, bir hastada sadece biyopsi yapılabildi. Patolojik incelemede tanılar, grade II astrositom (n: 2), pilositik astrositom (n:1), primitif nöroektodermal tümör (n: 1) ve glioblastoma (n: 1) idi. En sık uygulanan tedavi yaklaşımı radyoterapi + kemoterapi (n: 7, %35) idi. İzlem süreleri 1 ay ile 11 yıl arasında değişiyordu (median, 10,5 ay). Genel yaşam oranı %19,5 idi. Sonuç: Çocukluk çağının birçok kanserinde ve hatta beyin tümörlerinde multidisipliner yaklaşımlarla yaşam oranlarında artışlar olmasına karşın, özellikle diffüz intrensek pons gliomlarında maalesef istenilen başarı elde edilememiştir. Özellikle kemoterapide yeni tedavi yaklaşımlara ihtiyaç vardır., Objective: The aim of this study is to evaluate the clinical findings, treatment approaches and outcomes of our patients who were diagnosed and treated for brainstem tumor.Material and Method: Between 2006 and 2019, oncology files of patients diagnosed with brain stem tumor and treated were analyzed retrospectively in our clinic.Results: Twenty patients with brainstem tumor diagnosis were included in the study. The age of patients ranged from 2 to 16 years (median age, 6.5 years). The gender distribution was 14 males (70%) and 6 females (30%). The most common complaints were gait disturbance (60%), headache (45%), and strabismus (40%). The most common physical examination findings were ataxia (55%) and 6th cranial nerve palsy (55%). Tumor locations were pons (90%), bulbus (5%) and medulla (5%). Partial mass excision could be done in four patients, while only one biopsy could be performed in one patient. In the pathological examination, the diagnoses were grade II astrocytoma (n: 2), pilocytic astrocytoma(n: 1) primitive neuroectodermal tumor (n: 1) and glioblastoma (n: 1). The most common treatment approach was radiotherapy + chemotherapy (n: 7, 35%). Follow-up time varied between 1 month and 11 years (median, 10.5 months). The overall survival rate was 19.5%.Conclusion: Despite the increase in overall survival rates with multidisciplinary approaches in many cancers and even brain tumors of childhood, unfortunately the desired success could not be achieved especially in diffuse intrinsic pons gliomas. New treatment approaches are needed, especially in chemotherapy.

Background: Medulloblastoma is the most common central nervous system tumor in childhood. This study aims to evaluate the clinical features, treatments, and outcomes of pediatric patients diagnosed with medulloblastoma Materials and Method:Between 2006 and 2019, the medical records of children with medulloblastoma were reviewed retrospectively. Patients who died after surgery, before chemotherapy or radiotherapy were not included in the survival analysis Results: During the study period, 38 children were diagnosed with medulloblastoma. Twenty-one of the patients were male (55.3%) and 17 were female (44.7%). The ages of the children ranged from 3 months to 17 years (median age 8 years). The ages of five patients were under 3 years (13.1%). The most common complaints were headache (n: 26, 68.4%), imbalance (n: 21, 55.3%), and vomiting (n: 20, 52.6%). The mass sizes ranged between 3 and 6 cm in 32 patients (84.2%). At the time of diagnosis, 5 patients had seeding metastasis (13.1%). The most commonlyused chemotherapy protocol included vincristine, cisplatin, etoposide (60.5%). Five patients died after surgery without any chemotherapy or radiotherapy. Of the 33 patients included in the life analysis, 12 died (36.4%). Follow-up times ranged from 2 months to 14 years (median, 44 months). The overall survival rate was 59.1%. Eight patients had relapsed (24.2%). Late relapse was detected in 3 of the relapsed patients (relapse times were the 91st, 69th, and 72nd months). Conclusions: It is possible to achieve satisfactory treatment results in children with medulloblastoma using international treatment guidelines and recommendations, with an experienced professional team dedicated to pediatric neurooncology.

Signet ring cell gastric carcinoma is extremely rare during childhood. One of the most important problems in these patients is nutritional difficulty and impairment, and these patients are often supported by total parenteral nutrition. Herein, the authors report a case of Wernicke encephalopathy due to prolonged total parenteral nutrition in a 13-year-old girl with diffuse gastric cancer with signet ring cell.

To evaluate the clinical utility of the recently described absolute neutrophil counts to absolute lymphocyte counts ratio (NLR), absolute platelet counts to absolute lymphocyte counts ratio (PLR), and absolute monocyte counts to absolute lymphocyte counts ratio (MLR) on prognosis in children with Hodgkin lymphoma (HL).We retrospectively evaluated the clinical characteristics, laboratory features (lymphocyte counts, NLR, PLR, and MLR), treatment, and results of 52 children with HL in the Department of Pediatric Hematology and Oncology, Selcuk University, konya, Turkey, from January 2006 until December 2021.The patients included 27 (51.9%) females and 25 (48.1%) males. The age of the patients ranged between 3-17.5 years old (median: 9 years). There were 22 patients in stage II, 24 in stage III, and 6 in stage IV. The most prevalent histopathological subgroup was the nodular sclerosing type (53.8%). The 5-year overall survival rate was 93.7%. The overall survival rate differed based on lymphocyte counts (Lymphocyte counts, NLR, and PLR may be useful markers for determining the outcomes in children with HL.

Constitutional mismatch repair deficiency (CMMRD) is one of the rare cancer predisposition syndromes. The aim of this study was to evaluate the cerebral developmental venous anomalies in children with central nervous system tumors associated with CMMRD, an area in which there is extremely little experience.Data from children diagnosed with medulloblastoma and high grade central nervous sytem tumor were retrospectively collected. According to the European CMMRD criteria, nine patients were diagnosed as CMMRD syndrome and the others consisted of the group without CMMRD. All radiological examinations of these children were retrospectively reviewed. Whole exome sequencing was performed to index cases` germline DNA.Nine children from four families, six females and three males, were studied. The median age at the first tumor diagnosis was 4.5 years (range, 9 months to 14 years). All CMMRD patients had café au lait spots, but none fulfilled the diagnostic criteria for neurofibromatosis. The patients developed high-grade glial tumor (n: 7) and medulloblastoma (n: 2). The affected genes in the three families were MSH6 [c.478CT (p.Gln160Ter)], MSH6 [c.2871dupC (p.Phe958LeufsTer5)] and MLH1 [c.236GA(p.Arg79Lys)], respectively. Seven patients had multiple developmental venous anomalies; six patients had leptomeningeal enhancement; and five patients had cavernomas. None of these findings were present in the group without CMMRD.Constitutional mismatch repair deficiency should be considered when multiple developmental venous anomalies, cavernomas, and leptomeningeal enhancement are detected, especially in patients with café au lait spots.

Aim This study aimed to evaluate the clinical features, treatment approaches, and outcomes of glial tumors in children. Material and methods Files (2006 to 2020) of children diagnosed with glial tumors and followed-up were reviewed retrospectively. Information regarding demographic and clinical characteristics, treatment approaches, and outcomes were retrieved from the patients\' files. Results Of the total of 180 pediatric patients diagnosed with brain tumors, 73 (40.6%) had glial tumors. The children with astrocytoma were in the age range of 2-18 years (median age: 8.7 years), while the ages of children with ependymoma ranged from three months to 10 years (median age: 3 years). This difference was statistically significant (p 0.0001). The male to female ratio was 1.6. The most common symptoms or signs were headaches (n = 34, 46.6%), abnormal gait or coordination (n = 22, 30.2%), vomiting (n = 21, 28.8%), and cranial nerve palsies (n = 20, 27.4%). The pathological diagnoses were astrocytomas (n = 53, 72.6%), oligodendroglial tumors (n = 2, 2.7%), ependymoma (n = 15, 20.7%), and other glial tumors (n = 3, 4.1%). The most common tumor location was supratentorial (n = 42, 57.5%), while midline glioma was detected in seven patients. The 5-year overall survival (OS) rate of all glial tumors, astrocytoma, and ependymoma was 42%, 40%, and 55%, respectively. The 5-year OS rate of the tumor Grade I, II, III, and IV was 77.2%, 45%, 32%, and 0%, respectively (p 0.0001). The 5-year OS rate of supratentorial, infratentorial, and spinal tumors was 25.6%, 63.6%, and 50%, respectively (p = 0.021). In Cox regression analysis, it was found that the tumor resection and grade had an effect on the tumor prognosis. Conclusion Treatment results are not satisfactory in high-grade astrocytomas. There is a need for new treatment approaches that would take cognizance of molecular features and adopt multidisciplinary approaches.

Background: Biological inflammatory status in cancer patients is evaluated with various parameters. Limited studies have been conducted on this issue in children. Objectives: This study was done to evaluate the importance of the biological inflammatory status, including systemic inflammatory response index (SIRI), systemic immune-inflammation (SII) index, and hemoglobin-albumin-lymphocytes-platelets (HALP) score in children with cancer. Methods: Demographic characteristics, complete blood count, and biochemical analysis of the patients on admission were recorded retrospectively. Since not meeting the necessary assumptions, the Mann-Whitney U test was used for the comparison of the two groups, and the Kruskal-Wallis test was used for the comparison of more than two groups Results: The SIRI of the patients was statistically higher than the control group (P < 0.0001). Considering lymphoma, central nervous system tumors, and solid tumors, there was a statistical difference between the groups in SII index and SIRI (P values: .0245, and .0060, respectively). Regarding inflammatory biomarkers, according to the extent of cancer (localized or advanced disease), it was found that SIRI was higher in patients with advanced disease (P = 0.0175). The patients who died had a statistically higher HALP score (P = 0.0472). Conclusions: The inflammatory biomarkers can be used in childhood cancers to determine the extent of the disease and predict outcomes. However, in larger patient series, ideal values should be achieved by analyzing the receiver operating characteristic curves and the area under the curve.

This study investigates the role of socioeconomic adversity and armed conflict in executive function (EF), theory of mind (ToM) and empathy in a rarely studied group, children living in eastern Turkey. The data were collected from 115 children (60 girls) aged 39 to 95 months (M = 68.22, SD = 14.62). Results revealed that children’s performance was low in the EF and ToM tasks, and high in the empathy task. In path analysis, controlling for age, armed conflict experience predicted lower EF (β = − 0.15) and higher empathy (β = 0.21), and socioeconomic adversity predicted lower ToM (β = 0.20). These findings contribute to our knowledge on cognitive and emotional development of children who live in such disadvantaged contexts.

Purpose/background Glucagon-like peptide-1 (GLP-1) is a molecule used to treat type 2 diabetes mellitus (T2DM). Given their widespread expression in the nervous system, GLP-1 receptors also play a role in regulating mood and cognitive function. Here, we aimed to compare obese patients with T2DM, with or without exenatide (a GLP-1R agonist) use on cognitive and affective functioning. Methods/procedures A total of 43 patients with T2DM (23 on exenatide and 20 without exenatide) were evaluated with the Snaith-Hamilton Pleasure Scale, Cognitive Failures Questionnaire, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7, Childhood Trauma Questionnaire, Perceived Stress Scale (PSS), and Chronic Stress Scale, in addition to laboratory-based measures of reward learning (the probabilistic reward task) and working memory (Letter-N-Back task). Findings/results Patients on exenatide had higher body mass index (BMI) (37.88 ± 5.44 vs 35.29 ± 6.30; P = 0.015), PHQ-9 (9.70 ± 4.92 vs 6.70 ± 4.66; P = 0.026), and PSS (29.39 ± 6.70 vs 23.35 ± 7.69; P = 0.015) scores. Other stress scales (Childhood Trauma Questionnaire and Chronic Stress Scale), Generalized Anxiety Disorder-7 scores, response bias, or discriminability as assessed by probabilistic reward task and self-report (Cognitive Failures Questionnaire) and laboratory-based (Letter-N-Back) cognitive measures were not significantly different between groups (both Ps > 0.05). Multivariate linear regression analyses adding BMI and PSS as covariates revealed that although BMI had no effect (P = 0.5), PSS significantly predicted PHQ-9 scores (P = 0.004). Mediation analysis showed that exenatide users reported higher PSS, with greater PSS associated with higher PHQ-9 levels (b = 0.236). There was no evidence on exenatide directly influencing PHQ-9 independent of PSS (c' = 1.573; P = 0.305; 95% bootstrap confidence interval, -1.487 to 4.634). Implications/conclusions Based on previous research and our findings, exenatide use might be mediating depression scores through disrupting stress responses.

Aim: The aim of this retrospective study is to evaluate clinical features, treatment approaches and outcomes of children with ovarian mass. Materials and Methods: In our clinic, the oncologic charts of children with a mass in the ovary between 2009 and 2020 were analyzed retrospectively. The patients' demographic features, symptoms and signs, diagnosis, treatments and outcomes were noticed. Results: The age of 55 patients included in the study ranged from two months to 18 years (median, 12.9 years). While the ages of 38 patients were ≥ 10 years (69.1%), 17 of them were

Amaç: Bu çalışmanın amacı, çocuklarda primer malign böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçlarının değerlendirilmesidir. Gereç ve Yöntem: 2006 ile 2020 yılları arasında primer malign böbrek tümör tanısı alan ve izlenen çocuk hastaların onkoloji dosyaları geriye yönelik incelendi. Hastaların demografik ve klinik özellikleri ile tedavi yaklaşımları ve izlemleri not edildi. Bulgular: Bu yıllar arasında izlenen 950 malign hastalıklı çocuğun 49’unda(%5,2) primer malign böbrek tümörü vardı. Hastaların yaşı üç gün ile 13 yıl arasında değişiyordu (ortanca, 3 yıl). Erkek kız oranı 25/24’dü. En sık görülen semptom ve bulgu karında kitle idi. İki hastada bilateral hastalık vardı (%4,1). Patolojik tanılar, Wilms tümörü (n = 44, % 89,8), mezoblastik nefroma (n=2, % 4,1), böbreğin clear hücreli sarkomu (n=2, % 4,1) ve böbreğin primer sinovyal sarkomuydu (n=1, %2). Wilms tümörlü hastalardan sadece ikinde diffüz anaplazi vardı. Hastalarımızın risk grupları düşük (n = 4, % 8.3), orta (n = 35, % 72.9) ve yüksek riskli (n = 9, % 18.8) idi. Hastaların takip süreleri iki ay ile 15 yıl (ortanca, 5 yıl) arasında değişiyordu. Primer böbrek tümörlerinde genel ve olaysız sağ kalım oranları sırasıyla % 72,7 ve% 59,7 idi. Wilms tümörlü hastaların genel ve olaysız sağ kalım oranları %79 ve %63’dü. Sonuç: Primer malign böbrek tümörlerinde özellikle de Wilms tümöründe multidisipliner yaklaşımlarla başarı oranları yükselmiştir. Bundan sonra hem tedavi başarısının daha da artırılması hem de tedavi ilişkili yan etkilerin azaltılması üzerinde durulmalıdır., Objective: The aim of this study is to evaluate the clinical features, treatment approaches and outcomes of primary malign renal tumors in children. Material and Methods: The oncology charts of children diagnosed and followed up with primary malign renal tumors between 2006 and 2020 were retrospectively analyzed. Demographic and clinical characteristics, treatment approaches and follow-up of the patients were noted. Results: In this period, 49 of 950 children with malignant disease had primary renal kidney tumors (5.2%). The patients’ age ranged from three days to 13 years (median, 3 years). The male to female ratio was 25/24. The most common symptom and signs were abdominal mass. Both patients had bilateral disease (4.1%). Pathological diagnoses were Wilms tumor (n = 44, 89.8%), mesoblastic nephroma (n = 2, 4.1%), clear cell sarcoma of the kidney (n = 2, 4.1%), and primary synovial sarcoma of the kidney (n = 1, 2%). Only two of the patients with Wilms tumor had diffuse anaplasia. The risk groups of our patients were low (n=4, 8.3%), intermediate (n=35, 72.9%) and high risk (n=9, 18.8%). Follow-up periods ranged from two months to 15 years (median, 5 years). Overall and event free survival rates were 72.7% and 59.7%, respectively. Overall and event-free survival rates of Wilms tumor were 79% and 63%. Conclusion: Multidisciplinary approaches have increased success rates in primary malignant kidney tumors, especially in Wilms tumor. After that, it should be focused on both increasing the success of the treatment and reducing the treatment-related side effects.

Background Kartagener`s syndrome, a subgroup of primary ciliary dyskinesia, is characterized by situs inversus totalis, chronic sinusitis and bronchiectasis. To date, the association of malignant diseases and Kartagener`s syndrome has been reported and all cases except angioimmunoblastic T cell lymphoma in a child have been seen in adulthood. Case A 10-year-old boy who was followed with the diagnosis of Katagener`s syndrome, presented with a progressive mass in the cervical region for 6 months. Physical examination revealed mental retardation, multiple lymphadenopathies, the largest in the left cervical region (4x4 cm), and pectus carinatum. Also, on cardiovascular examination, apex beat was felt on the right fifth intercostal space along midclavicular line. Magnetic resonance imaging of nasopharynx showed narrowing of the nasopharyngeal airway with an increase in wall thickness up to 2.5 cm on the posterior wall of the nasopharynx. Also, bilateral multiple cervical lymphadenopathies were noted. The pathological examination of the biopsy from cervical lymphadenopathy revealed a diagnosis of undifferentiated nasopharyngeal carcinoma. Chemotherapy was started for nasopharyngeal carcinoma chemotherapy regimen including cisplatin, docetaxel, and 5-fluorouracil. After four cycles of chemotherapy there was a significant regression in nasopharyngeal mass and lymphadenopathies. The patient underwent radiotherapy to the nasopharynx and bilaterally cervical regions. The patient has been in follow-up for 6 years well and tumor free. However, he is still under the supervision of the pediatric immunology and allergy departments due to recurrent respiratory infections and sinusitis. Conclusion We present a case of nasopharyngeal carcinoma which developed in a child with Kartagener`s syndrome. To our knowledge, this is the first report of nasopharyngeal carcinoma in a child with Kartagener`s Syndrome.

Socioeconomic status is a strong predictor of normative development and well-being in young people. It is well-known that growing up in a socioeconomically disadvantaged context may lead to negative outcomes, both in childhood and in adulthood. Early intervention and prevention programmes are crucial for building resilience and improving health, well-being and equity. Bounce Forward is a school-based prevention programme implemented in Blackpool, a town in the United Kingdom facing multiple challenges. It was part of a whole town resilience approach and nascent global social movement known as the “Resilience Revolution.” Between 2017 and 2019, the programme was delivered in all Year 5 classes at every primary school in Blackpool (nschool = 36), reaching out to 3,134 students (ages 9–10; 50.4% male). The programme aimed to increase resilience in young people by building knowledge and skills about mental health and resilience through 10 sessions. In the current study, we longitudinally examined a range of protective factors, which are relevant to young people's resilience, as well as their mental health outcomes at three time points: before they participated in Bounce Forward, at the end of the programme, and 3–5 months later, when they started Year 6. The current sample included 441 Year 5 students (54.2% male) from 11 primary schools in Blackpool. Nineteen teaching staff also participated in the study and provided qualitative data regarding the impact of the programme on their students. Results showed improvement in some areas of young people's resilience after taking part in Bounce Forward. We also identified gender differences in several protective factors, indicating that boys may need further support. Teaching staff highlighted improvements in various areas; and also observed that their students have been using the strategies that they learnt from the programme. Altogether, findings suggested that young people benefitted from Bounce Forward. The programme is sustainable, offering a free to download teacher resource pack that allows schools to self-deliver it.

Objective: To review retrospectively the demographic and clinical features and treatment approaches of patients with ovarian dysgerminoma.Material and Methods: The files of pediatric patients diagnosed with ovarian dysgerminom between 2006-2020 at XXXXX University Faculty of Medicine, Department of Pediatric Oncology were reviewed retrospectively.Results: Ten patients with dysgerminoma were included in the study. The ages of the patients ranged from 8 to 17 years (median, 12.5 years). While the mass was unilateral in nine patients (90%), it was bilateral in one patient (10%). In all patients, complaints of application were abdominal swelling and abdominal pain. Ovarian torsion developed in one patient. Preoperative alpha-feto protein levels were within normal limits in seven patients, while hCG levels were high in all seven patients. The lactate dehydrogenase enzyme level was measured in five patients and was high in all. Five patients underwent primary surgery, and all of these patients were in stage I. Additional treatment was not given. Neoadjuan treatment was applied in three patients due to bilateral disease or common disease. The follow-up time of patients ranged from one year to 13 years (median, 5.5 years). The overall survival rate of the patients was 87.5%.Conclusion: Disgerminoma should be considered in rapidly developing intraabdominal masses especially in peripubertal girls and treatment planning should be done accordingly., Amaç: Over disgerminomu tanısı ile izlenen hastala­rın demografik ve klinik özellikleri ile tedavi yaklaşımlarını geriye dönük olarak incelemektir.Gereç ve Yöntem: XXXXXX Üniversitesi Tıp Fakültesi Çocuk Onkoloji Bilim Dalı’nda, 2006-2020 yılları arasında over disgerminom tanısı alan çocuk hastaların dosyaları geriye dönük olarak incelendi.Sonuç: On disgerminom tanısı alan hasta çalışmaya dâhil edildi. Hastaların yaşları 8 ile 17 yıl arasında değişmekteydi (ortanca, 12,5 yıl). Dokuz hastada kitle tek taraflı iken (%90), bir hastada iki taraflıydı (%10). Tüm hastalarda, başvuru şikâyetleri karında şişlik ve karın ağrısı idi. Bir hastada over torsiyonu gelişmişti. Yedi hastada ameliyat öncesi alfa föto protein düzeyleri normal sınırlarda iken, hCG düzeyleri yedi hastanın tamamında yüksekti. Laktat dehidrojenaz enzim düzeyi beş hastada bakılmıştı ve hepsinde yüksekti. Beş hasta primer cerrahi uygulandı ve bu hastaların tamamı evre I’di ek tedavi verilmedi. Üç hastada, bilateral hastalık ya da yaygın hastalık nedeniyle neoadjuan tedavi olarak uygulandı. Hastaların izlem süreleri bir yıl ile 13 yıl arasında değişmekteydi (ortanca, 5,5 yıl). Hastaların genel yaşam oranı % 87,5 idi. Yorum: Özellikle ergenlik çağına yakın kız hastalarda hızlı büyüyen karın içi kitlelerde disgerminom akla gelmeli ve tedavi planlaması buna göre yapılmalıdır.

Background Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast lesion that is is extremely rare in children and adolescents. Case A 13-year-old girl was admitted to our clinic with a giant mass in the left breast for 3 months. Physical examination findings of the patient were normal except for the mass in the breast. The mass was removed totally, and its pathological diagnosis was pseudoangiomatous stromal hyperplasia. The patient has been followed up for 6 months without disease.

The aim of this study is to evaluate the clinical and laboratory findings of pediatric patients with non-Hodgkin lymphoma (NHL) who developed Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Between 2006 and 2018, the medical records of child patients with NHL who developed SJS and TEN were reviewed retrospectively. SJS/TEN developed in 7 of 70 patients with NHL (10%). The pathologic subgroups of the patients with SJS/TEN were ALK-negative anaplastic large cell lymphoma (n: 3), Burkitt lymphoma (n: 2), lymphoblastic lymphoma (n: 1), and primary mediastinal B-cell lymphoma (n: 1). Five patients had TEN, 1 patient had SJS/TEN, and 1 patient developed only SJS. In 5 patients, both steroids and intravenous immunoglobulin were administered for treatment, and clinical improvement was achieved in 3 of these patients. Only steroid treatment was used for 1 patient, whereas for the other patient, intravenous immunoglobin was preferred. In addition, N-acetylcysteine treatment was administered for these 2 patients. Four patients with acute renal failure died, and it was found that SJS/TEN is observed more frequently in patients with NHL in which intensive treatment protocols with high-dose methotrexate are used more than with other childhood malignant diseases. Early diagnosis and administration of appropriate and supportive treatment approaches may improve the prognosis.

The aim of this study was to determine cancer susceptibility syndromes (CSSs) in children with lymphoma and solid tumors and to evaluate their effects on overall survival rates. Between 2006 and 2019, the oncologic charts of 672 patients who were followed-up with a diagnosis of lymphoma and solid tumor in our clinic were retrospectively reviewed. CSSs were detected in 42 children (6.25%). The most common CSS was DNA damage repair defects/genetic instability (in 18 of 42 patients with CSSs, 42.8%). In the patients with CSSs, 48 different cancers developed. The most common types of cancer were lymphoma (n: 10, 21%) and high-grade glial tumor (n: 9, 19%). The lymphoma subgroups were very rare childhood lymphomas, such as gray zone lymphoma and marginal zone lymphoma. The overall survival rates for patients with DNA damage repair defects/genetic instability; with CSSs other than DNA damage repair defects/patients with genetic instability syndrome; and without any CSS, were 9.7%, 65.1%, and 68.7%, respectively. The overall survival rate for patients with DNA damage repair defects/patients with genetic instability syndrome was lower than both patients with CSSs other than DNA damage repair defects/genetic instability syndrome (P=0.002) and those without any CSS (P

A 3-year-old girl presented with fever and left-sided neck mass that did not resolve despite antibiotic treatment. Physical examination was normal except lymphadenopathy in the left cervical region. Complete blood count was Hb: 8.01 g/dL, leukocyte count: 4034/mm3, platelet count: 286,000/mm3. On preoperative period, coagulation studies revealed a prolonged activated partial thromboplastin time (aPTT, 46.1 s [N: 21 to 36]), corrected mixing test for aPTT. The prothrombin time and international normalized ratio were in normal limits. Factor VIII levels, von Willebrand factor antigen, and ristocetin cofactor were normal. After the patient was given fresh frozen plasma, lymph node excision was performed. As a result of pathologic examination, Hodgkin lymphoma was diagnosed as classic type. The patient was instituted ABVD chemotherapy protocol for Hodgkin lymphoma. The aPTT at the sixth day of treatment was within normal limits. Coagulation test abnormalities are extremely rare in Hodgkin lymphoma. To our knowledge, this is the first report of prolonged aPTT in a child with Hodgkin lymphoma.

The authors present a case of delayed radiation myelopathy in a 12-year-old girl with Hodgkin lymphoma and Artemis mutation. This is the first of such a case presented in the literature.

Children living in armed conflict zones are often exposed to political violence and other risk factors that may be caused or exacerbated by the conflict, such as poverty and family violence. If left untreated, these experiences may cause psychological problems throughout life. This study investigated the psychological well-being of children living in the low-intensity armed conflict zone in Turkey in relation to their adverse experiences. We collected data from 409 caregivers for their children (236 girls) aged 5.5 to 18 years (mean [M] = 11.50, standard deviation [SD] = 3.65). Caregivers provided information regarding their children's emotional and behavioral problems (internalizing, externalizing, and total problems; posttraumatic stress symptoms [PTSS]), income, family violence, and armed conflict experiences. Caregivers reported moderate levels of problems among children. The prevalence of borderline/clinical (T ≥ 60) scores was 14.3% for internalizing, 12.6% for externalizing, and 14% for total problems and 7.9% for PTSS. Notably, almost all families resided in extreme poverty. The prevalence of family violence was 36%. Children were frequently exposed to conflict-related events. Hierarchical regressions showed that after controlling for the role of demographic variables and other risk factors, income predicted total problem level (β = -.10), and family violence (βs = .17 to .26) and armed conflict (βs = .13 to .20) experiences predicted internalizing, externalizing, and total problems and PTSS levels. Our findings suggest that family violence and armed conflict pose a significant risk to children's psychological well-being and inform intervention strategies and policy decisions to promote welfare in such disadvantaged contexts. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Hirschsprung disease is a developmental disorder of the enteric nervous system and is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the distal intestine. This condition results in absence of peristalsis in the affected bowel and the development of a functional intestinal obstruction. It occurs in approximately 1 in 5000 live born infants and usually presented with delay in the meconium passage, distended abdomen, feeding intolerance and bilious vomiting. Here in, clinical and radiological evaluation of a male infant who diagnosed with Hirschsprung's disease in the neonatal period was presented., Hirschprung Hastalığı enterik sinir sisteminin gelişimsel bir bozukluğu olup distal kolondaki myenterik ve submukozal pleksuslarda ganglion hücrelerinin yokluğu ile karakterizedir. Bu durum etkilenen barsak kısmında peristaltizmin yokluğuna ve fonksiyonel intestinal tıkanıklığa yol açar. Yaklaşık 5000 canlı doğumda bir görülmekte ve genellikle mekonyum çıkışında gecikme, karın distansiyonu, beslenme intoleransı ve safralı kusma ile karşımıza çıkmaktadır. Burada yenidoğan döneminde Hirschprung Hastalığı tanısı konulmuş erkek bebeğin kliniği ve radyolojik tetkikleriyle değerlendirilmesi sunulmuştur.