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Delirium, a potentially reversible, acute-onset organic brain syndrome, is a behavioral manifestation of acute brain dysfunction associated with underlying medical conditions. It presents as marked and inconsistent mental changes characterized by dysregulated states of focus and cognition. It can be caused by several different causes, including infections, drugs, toxins, metabolic disorders, and a number of other medical conditions. This case report presents a 4-year-old girl with short bowel syndrome, who developed hyperactive delirium due to acute metabolic acidosis.

Objective Neonatal sepsis is one of the most important causes of neonatal morbidity and mortality. Symptoms and signs of neonatal sepsis can be silent; therefore, laboratory investigation is necessary in cases of doubt or if there are risk factors. Early diagnosis is important for early intervention and treatment. The most valuable method for diagnosis is blood culture; however, false positivity due to contamination or false negativity despite ongoing fatal bacterial infections can be seen. Pentraxin 3 is a prototype of the long pentraxin family. It has some differences from C-reactive protein (CRP) in terms of gene organization and localization and production site. It is effective in the early phase of inflammation and it is detected as an early marker of sepsis in adults. The aim of this study was to investigate whether pentraxin 3 can be used as a marker in neonatal sepsis. Materials and Methods Thirty newborns with suspected sepsis with antenatal history or the presence of clinical signs of sepsis, such as hypo/hyperthermia, feed intolerance, lethargy, hypotonia, irregular cardiac rhythms, bradycardia, cyanosis, apnea, respiratory distress, or metabolic acidosis, were enrolled in the study as a case group, and 28 healthy newborns were included as a control group. Serum pentraxin 3, procalcitonin, CRP, and hemogram in the study group and serum procalcitonin and pentraxin in the control group were examined. Results Serum pentraxin 3 (pg/mL) and serum procalcitonin (ng/mL) levels were 2,273.82 ± 1,260.75 and 0.86 ± 0.52 in the case group and 957.41 ± 268.00 and 0.19 ± 0.18 in the control group (p Conclusion The present study showed that serum pentraxin 3 levels may be a useful marker in the diagnosis of neonatal sepsis.

Potocki Lupski ve Smith Magenis sendromları insan 17. kromozom kısa kolu (11.2 bandı) ile ilişkili sendromlardır. Bu bölgenin duplikasyonu Potocki Lupski, delesyonu ise Simth Magenis sendromu olarak tanımlanmaktadır. Çocukluk çağında nadir görülen bu hastalıkların tipik fenotipik özellikleri olsa da tanı ileri genetik analizlerle konulmaktadır. Bu makalede nörolojik gelişimsel gerilik başta olmak üzere bu iki sendromun neden olduğu diğer nörolojik komplikasyonları belirtmeyi ve pediyatri klinisyenlerinin bu sendromlara dikkatini çekmeyi amaçladık. Potocki Lupski and Smith Magenis syndromes are associated with the human 17th chromosome short arm (11.2 band). Duplication of this region is defined as Potocki Lupski syndrome, and its deletion is defined as Smith Magenis syndrome. Although these diseases, which are rare in childhood, have typical phenotypic features, the diagnosis is made with advanced genetic analysis. In this article, we aimed to point out especially neurological developmental delay and other neurological complications caused by these two syndromes and draw the attention of pediatric clinicians to these syndromes., Potocki-Lupski and Smith-Magenis syndromes are associated with the human 17th chromosome short arm (11.2 band). Duplication of this region is defined as Potocki-Lupski syndrome, and its deletion is defined as Smith-Magenis syndrome. Although these diseases, which are rare in childhood, have typical phenotypic features, the diagnosis is made with advanced genetic analysis. In this article, we aimed to point out especially neurological developmental delay and other neurological complications caused by these two syndromes and draw the attention of pediatric clinicians to these syndromes.

Giriş: FMF seröz zarların ağrılı inflamasyonu ile karakterize tekrarlayan ateşin eşlik ettiği genetik bir hastalıktır. Çoğunlukla Ermeniler, Türkler, Araplar ve Yahudiler etkilenir. Ailesel Akdeniz Ateşinde uzun süreli inflamasyon atriyal iletim süresinin bozulmasına ve atriyal fibrozise yol açabilir. Bu çalışmada Ailesel Akdeniz Ateş olan çocuklarda atriyal iletim süresini değerlendirmeyi amaçladık.Yöntem: Çalışmaya Ekim 2015-Ekim 2016 tarihleri arasında Çocuk Sağlığı ve Hastalıkları Polikliniğimizde 36 FMF (17 erkek / 19 kız) tanılı hasta ile 20 kontrol (7 erkek / 13 kız) olgusu dahil edildi. Doku Doppler Ekokardiyografi ve interatriyal elektromekanik gecikme ölçümleri yapıldı. P dalga dispersiyonu (pdisp), 12 derivasyonlu elektrokardiyogramdan hesaplandı.Bulgular: FMF hastalarında inter-atriyal (Lateral PA– Trikuspid PA) ve intra-left (Lateral PA-Septal PA) atriyal elektromekanik gecikme anlamlı olarak daha uzundu (P, Introduction: Familial Mediterranean Fever (FMF) is a disease with recurrent fever, characterized by painful, noninfectious inflammation of the serous membranes. It mostly affects Armenians, Turks, Arabs and Jews. Prolonged inflammation in FMF may lead to atrial fibrosis which can cause the deterioration of atrial conduction time and refractory periods of atrial myocardium.In the present study we aimed to assess atrial conduction time in children with FMF.Methods: The study included 36, children diagnosed with FMF(17 males/19 females, 13 (7-15) years) and 20 control(7 males/13 females, 11 (9-16) years) cases in our Pediatric Outpatient Clinic between October 2015 and October 2016. Tissue Doppler Echocardiography (TDE) measurements of intra-and interatrial electromechanical delay were done. P wave dispersion (Pdisp) was calculated from the 12-lead electrocardiogram.Results: Inter-atrial (Lateral PA– Tricuspid PA) and Intra-left (Lateral PA-Septal PA) atrial electromechanical delay were significantly longer in FMF patients (P

Background: Previous studies revealed there are many gaps in the awareness and knowledge regarding the diagnosis and management of drug allergy (DA) among various health-care professionals. Objective: To assess the knowledge, attitudes, and practices towards DA among residents and interns of 3 university hospitals in the region of Trakya (Thrace), Turkey. Methods: A cross-sectional survey was conducted at university hospitals of 3 cities in the Trakya region: 1. Trakya University Medical Faculty, Edirne (n = 405), 2. Namik Kemal University Medical Faculty, Tekirdag (n = 114), and 3. Canakkale 18 Mart University Medical Faculty, Canakkale (n = 111). A Turkish questionnaire was developed based on previous published studies. Results: The majority of participants (67%) had not received education on DA as a separate subject during their medical education. Less than a third (28.3%) of all respondents were satisfied with their knowledge concerning patients with clinical signs of DA. Of the 6 knowledge questions on DA, the average score for the study was 3.51 out of 6 (58.5%). Residents had a higher knowledge score (3.93 +/- 1.1) compared with interns (3.05 +/- 1.2) (p < 0.001). The lowest percentage of correct answers were in response to questions on laboratory confirmation of drug-related anaphylaxis (14.5%) and the possibility of penicillin toleration in patients with a history of penicillin allergy (11.8%). The majority of participants (92%) believe that medical doctors should be educated in DA. There were no significant correlations between taking DA histories and the frequency during daily practice of encountering patients. Conclusion: Our study revealed that DA knowledge and attitudes are not at satisfactory level among respondents, and we concluded the importance and necessity of reinforcement of DA education in pre- and postgraduate education of medical doctors.

Introduction: The present study aimed to evaluate macular and choroidal thicknesses in children with MEFV gene mutations.Methods: Thirty-five children with MEFV gene mutations and 40 healthy controls were included in the study. MEFV gene profiles for the current cohort were genotyped by Pyrosequencing and direct Sanger sequencing techniques. The thicknesses of the macular and choroid of each subject’s right eye were measured using spectral-domain optic coherence tomography.Results: Mean arteriolar and venular diameters were 95.75±11.98 µm and 127.61±10.44 µm in children with the MEFV gene mutations and 110.19±11.10 µm and 138.54±10.04 µm in control group respectively. Children with the MEFV gene mutations were found to have a significantly less mean arteriolar diameter (p

Introduction: There is insufficient study on the genetic clustering of nodular goiter. Although twin studies have proved genetic clustering, there is no prospective study on this topic. The aim of this study is to investigate the existence of familial clustering by evaluating the prevalence of thyroid nodules in the children of families with nodular goiter.Methods: The prevalence of thyroid nodules was calculated by evaluating the thyroid ultrasound results of children from families with and without nodular goiter.Results: Nodular goiter was detected in 5 children (3.4%), 2 (2.5%) from families with nodular goiter history and 3 (4.7%) from the control group. There was no statistically significant difference between these two groups.Conclusions: This is the first prospective study to investigate the familial aspect of nodular goiter disease. In our study, children with nodular goiter were the target group. Following statistical analysis, clustering of nodular goiter was observed in the children of patients with multinodular goiter.

Objective In the childhood period, diagnosis of primary headache is based on anamnesis essentially. This study investigated the effects of characteristics of headache (type of pain, localization and attack time), family migraine history and total duration from onset of headache to clinical diagnosis on primary headache diagnosis. Patients and Methods Headache history was taken from children aged 6–18 years with a suitable form of International Classification of Headache Disorders, 3rd edition. Children's demographic findings were recorded. Headache characteristics (type of pain, localization and attack time), whether there is family migraine history and total duration from onset of headache to clinical diagnosis were recorded and sensitivity and specificity were calculated. The effects of pulsatile pain, forehead localization, attack time ≥2 h, family history of migraine and total time from onset of headache to clinical diagnosis on final diagnosis of primary headache (migraine without aura or others) were also assessed with regression analysis. Results Of a total of 277 patients, 52 % were diagnosed with migraine without aura. Regression analysis revealed that family history of migraine was the most determinant factor for migraine without aura diagnosis (OR 2.922, 95 %CI 1.622–5.264). This was followed by the pursuing risk coefficients for migraine without aura diagnosis in order of forehead localization (OR 2.751, 95 %CI 1.537–4.923), attack time of ≥2 h (OR 2.615, 95 %CI 1.406–4.864), nausea (OR 2.163, 95 %CI 1.192–3.924), pulsatile pain (OR 2.102, 95 %CI 1.185–3.729) and total duration (OR 1.973, 95 %CI 1.105–3.521). Conclusion Family history of migraine and total duration of longer than 6 months from onset of headache to clinical diagnosis may be additional markers for migraine without aura diagnosis. Due to difficulties experienced in diagnosis of primary headache based on anamnesis in the childhood period, there is a need for additional diagnostic markers.

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323, WOS: 000534242500056, PubMed: 31851725, Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs., Turkish Neonatal Society [2-2016]; Turkish Neonatal Society, This study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

WOS: 000395946300003, PubMed ID: 28289585, The aim of the current study was to determine the frequency of the Mediterranean fever (MEFV) gene pathogenic variants in 60 children diagnosed with familial Mediterranean fever (FMF) and to compare the phenotype-genotype correlation. Genomic DNA was isolated by the spin-column method from peripheral blood samples (collected in vacutainers containing EDTA) and buccal smears. The MEFV gene profiles for the current FMF cohort were genotyped by pyrosequencing and direct Sanger sequencing techniques for the target pathogenic variants. The most prominent clinical symptoms were abdominal pain (53.4%), fever (23.4%) and arthritis (23.3%). Eighteen different pathogenic variants were identified and the most frequent were p. Met694Val (20.0%), p. Glu148Gln (13.3%), p. Met680 Ile (11.7%) and p. Arg202Gln (11.7%). Abdominal pain, fever and arthritis were the most common presenting clinical characteristics. Results showed that not only clinical characteristics, but also genotyping of the MEFV gene is needed to establish the correct diagnosis of FMF in children and other family members.

Background: This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma. Materials and Methods: In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined. Results: Mean age of children was 9.5 ± 3.1 years, 14 children (58.3%) had mild, 9 children (37.5%) had moderate, and 1 children (4.2%) had severe head trauma according to the Glasgow coma scale. Mean duration time after head trauma was 29.4 ± 9.8 months. In all cases, no pathologic condition was determined in the pituitary hormonal axis. In one children (4.2%), low basal cortisol level was found. There were no children with hormonal deficiency in this study. Conclusion: Although pituitary dysfunction after head trauma may develop in the early period, some may present in the late period; therefore, all cases should be followed up at outpatient clinics for a longer period.

Introduction: Fetal macrosomia is a condition with heterogeneous etiologic factors and its’ frequency is increasing in recent years. Many macrosomic infants are born without any risk factors and accurate prediction of macrosomia is not possible with only single risk factor. The aim of this study was to research the characteristics of healthy mothers without diabetes who gave birth to macrosomic infants. Materials and Methods: This case-control study comprised 291 healthy pregnant women who were monitored and delivered at Mardin Women and Children’s Hospital. Inclusion criteria were (a) no disease or conditions that may affect birth weight, (b) normal healthy pregnancy and (c) singleton live infants born between 37-42 weeks with no structural defects. A birth weight above 4.000 g was defined as macrosomic neonate. The study group was divided in two; group 1 had a birth weight less than 4.000 g and group 2 had a birth weight above 4.000 g. Characteristics of mother and newborn were analyzed to determine any association with macrosomia. Results: The logistic regression analysis results indicated that the risk of macrosomic infant were male gender of the infant [odds ratio (OR): 3.39; 95% confidence interval (CI): 2.010-5.211; p

Purpose To evaluate the retinal vascular diameters and macular and subfoveal choroidal thicknesses of obese and nonobese children using enhanced-depth imaging spectral domain optical coherence tomography (EDI SD-OCT). Methods The retinal vascular diameters of the 4 largest retinal arterioles and venules and macular and subfoveal choroidal thickness measurements of 40 obese children (body mass index [BMI] z score above +2.0 standard deviations) were obtained by EDI SD-OCT and compared with those of 40 age- and sex-matched nonobese children. Anthropometric measures, including weight and height, were also obtained. BMI z score was defined using standardized protocols. Results The mean BMI z scores of obese children were 2.59 ± 0.62; of nonobese children, −0.20 ± 0.92. The mean diameter of retinal arterioles was significantly smaller ( P = 0.002) in obese children compared to nonobese children, whereas the mean diameter of retinal venules was larger ( P = 0.008). The macular and subfoveal choroidal thicknesses were significantly thinner ( P = 0.031 and 0.014, resp.) in obese children compared to nonobese children. Conclusions The narrower retinal arterioles, wider retinal venules, and thinner macular and subfoveal choroidal thicknesses in obese children seem to be associated with microvascular impairments in childhood obesity.

Amac: Mekonyum pasaji yenidoganin genel saglik durumunun ve gastrointestinal sistemin butunlugunun iyi bir gostergesidir. Infantil koligin etiyolojisinde gastrointesitinal ve gastrointestinal olmayan hipotezlerin ikisi de vardir. Bu calismanin amaci ilk mekonyum zamaninin infantile kolik gelisimini ongorup ongoremeyecegini belirlemekti. Yontem: Calisma ardisik dogan 248 saglikli term, tekiz yenidogan ile yurutuldu. Demografik degiskenler, ilk beslenme zamani, ilk mekonyum zamani, ilk mekonyuma kadar beslenmesayisi ve yasamin ilk 3 gunu boyunca defekasyon sayisi kaydedildi. Yenidoganlarin ozellikleri infantile kolik ile iliskisi acisindan analiz edildi. Bulgular: Ilk mekonyum zamani infantile koligi olan ve olmayan gruplarda sirasiyla 9,7±10,2 saat ve 6.8±7.8 saatti (p=0,014). Infantil kolik riski dogumdan sonra 5,75 saate kadar ilk mekonyum cikisi olmayanlarda 1,99 kat (%95 CI: 1,13-3,51) ve ilk 72 saatte 17’den fazla defekasyonu olmayanlarda 2,11 kat (%95 CI: 1,19-3,74) artmis olarak saptandi. Sonuc: Dogum sonrasi ilk 5,75 saatte ilk mekonyumunu cikarmayan ve ilk 72 saatinde diskilama sayisi 17’den az olan yenidoganlar icin infantile kolik gelisme riski vardir.

Background: Childhood obesity is one of the important risk factors for early atherosclerosis. We aimed to evaluate the effect of obesity on abdominal aortic intima media thickness (aaIMT) in children. Methods: We consecutively recruited 60 obese and 28 healthy children from the outpatient clinic of pediatrics. In all patients, BMI, waist circumference (WC) and hip circumference (HC) were measured, and fasting serum lipid profile, plasma glucose and plasma insulin were studied. Homeostasis model assessment-estimated insulin resistance (HOMA-IR) was calculated for the obese group. All children underwent ultrasonography to evaluate hepatosteatosis and to measure aaIMT. Results: There was a significant difference between the groups in terms of aaIMT, insulin, glucose, HOMA-IR, total cholesterol, low-density lipoprotein, triglyceride and hepatosteatosis. aaIMT was 1.12 ± 0.25 and 0.61 ± 0.18 mm in the obese and nonobese groups, respectively (p < 0.001). In the obese group, there was a positive correlation between aaIMT and WC, WC/height ratio, BMI, HC and hepatosteatosis (p < 0.05 for all), with the highest significance for WC. Conclusions: This study showed that aaIMT was significantly higher in obese children than in nonobese children, and that WC was a strong predictor for aaIMT. Early detection of an increased aaIMT in obese children may guide the follow-up of these patients in terms of developing atherosclerosis and its complications.

Objective: It is known that general and local anesthesia practices disrupt the delicate balance of thermoregulation center which is already sensitive to very tiny differences of temperatures in a normal subject. We aimed to evaluate and compare the rectal temperatures of newborns born with normal vaginal delivery and cesarean section.Methods: We performed a prospective study of 106 term newborn - 40 born with normal vaginal delivery (group 1) and 66 born with cesarean section [51 spinal anesthesia (group 2), 15 general anesthesia (group 3)]. Only term babies were included in the study. Babies of eclamptic, pre-eclamptic and diabetic mothers and babies with chronic systemic diseases were excluded. Pregnants who underwent elective cesarean section were included in the study. Adolescent pregnants, pregnants with increased risks and pregnants with complicated operations were excluded. Mothers' temperatures were measured before and after the interventions. Rectal temperatures of the babies were measured immediately after birth.Results: Environmental temperature was maintained at 22-24 degrees C. Pre-operative mother temperatures were 36.310.30 degrees C in group 1, 36.36 +/- 0.26 degrees C in group 2 and 36.39 +/- 0.19 degrees C in group 3 (p=0.414). Post-operative mother temperatures were 36.39 +/- 0.27 degrees C in group 1, 36.29 +/- 0.31 degrees C in group 2 and 36.25 +/- 0.28 degrees C in group 3 (p=0.215). Rectal temperatures of the babies born with normal vaginal delivery were significantly higher than the others. It was lowest in the general anesthesia group (37.5 +/- 0.6 degrees C, 37.2 +/- 0.2 degrees C and 36.8 +/- 0.4 degrees C in group 1, 2 and 3, respectively). The temperature differences between groups were statistically significant p

Objective: The aim of this study was to evaluate whether exposure to second-hand smoke affected the six-minute walk test (6MWT) of obese non-asthmatic pediatric cases. Methods: Obese pediatric patients (body mass index >95th p) with no existing co-morbidities were included in the study. Smoke exposure was assessed with a self-reported questionnaire completed by the parents. The subjects were divided into two groups: Group 1 consisting of obese children exposed to passive smoking and Group 2 of obese children not exposed to passive smoking. In addition to 6MWT, spirometric flow and volume, including forced expiratory volume in 1 s and peak expiratory flow rate, were also measured in all subjects. The results of the 6MWT were assessed to determine any association with passive smoking. Results: The study included 75 obese pediatric cases (40 male, 35 female) with a mean age of 9.06±0.97 years. The 6MWT results in Group 1 was 501.88±62.12 meters and in Group 2 559.63±72.93 meters. The difference was statistically significant (p=0.001). Conclusions: Passive smoking may negatively affect the respiratory and cardiovascular capacity in obese children, who are already at risk of lower cardiopulmonary function. The evaluation of 6MWT in these pediatric patients may be useful for monitoring and families should be warned about potential problems due to smoking.

Objective: To evaluate the left venticular myocardial deformation parameters in normotensive obese children and adolescents by using 2-D speckle tracking echocardiography. Methods: This observational cross-sectional study included 69 children and adolescents (aged between 10-18), 38 were normotensive obese and 31 were normal weighted. All children underwent detailed two- dimentional, Doppler and two-dimentional speckle tracking echocardiography. Student t-test, Mann-Whitney U test, chi-square test and Pearson’s correlation were used in statistical analysis. Multiple linear regression analysis was used the determine independent variables on global longitudinal strain (GLS). Results: While in normal limits, diastolic blood pressure was significantly higher in obese group. Left ventricular end-diastolic diameter (LVDd) and end-systolic diameter (LVDs), interventricular septal thickness (IVSd), left ventricular posterior wall thickness (LPWD) and left ventricular mass index (LVM)/height2.7 were significantly higher in obese group compared to healthy peers (p=0.004, p=0.011, p

Mustafa Tekin, Şule Yıldırım, Hakan Aylanç, Nazan Kaymaz, Fatih Battal, Naci Topaloğlu, Esra Başer, Fatih Köksal Binnetoğlu Department of Pediatrics, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey Background: This study aimed to assess whether there was a difference in the pain-perception levels of newborns born to mothers who smoked during pregnancy and newborns born to mothers who were not exposed to active or passive smoking during pregnancy. Materials and methods: A total of 60 newborns born by normal spontaneous vaginal birth between June 2013 and June 2014 were included in the study: 30 born to mothers who smoked during pregnancy, and 30 born to mothers not exposed to smoking. Mothers or newborns who had taken analgesics or sedative medications in the previous 24 hours, newborns not born at term, and sick newborns were not included in the study. During the routine hepatitis B-vaccination injection given at postnatal 48 hours, the newborns’ behavior was monitored and recorded by video camera. The data obtained from the recordings were evaluated according to the Neonatal Pain, Agitation, and Sedation Scale and analyzed with SPSS 20. Results: The median pain score of the group exposed to tobacco smoke in utero was 8.5, while the median pain score of the unexposed group was 6 (P

Objective: Psychological state may affect the body weight through the hypothalamus and vice versa. The goal of this study is to investigate whether body mass index affect mindfulness awareness (MA) levels and type of coping with stress. Methods: Healthy adolescents were included in the study. The mindfulness attention awareness scale (MAAS), indicating the ways of coping checklist inventory was performed and body mass index (BMI) (kg/m2) of adolescents were calculated. The influence of BMI on MA and ways of coping with stress was tested. According to BMI percentiles the study population was grouped as obese (including overweight), normal-weighted and underweight. Results: A total of 270 adolescents (mean age: 13.63±2.07 years; 165 female/105 male) participated in the study. No significant correlation was found between BMI and MA scores (r=−0.085; p=0.161) and coping strategies were not different between the groups. When MA scores are compared with stress coping methods, it appeares that participants with high awareness levels chose positive coping styles. Conclusion: BMI is not effective on MA levels and choice of stress coping methods. But the higher MA levels are associated with positive coping styles.

Background: It is known that the biochemical marker linked to tissue ischemia, ischemia-modified albumin (IMA), is related to oxidative stress. Cigarette smoking is a situation with increased oxidative stress causing cell damage and it is thought that many of the negative effects linked to smoking may occur after the biological material in the body is exposed to oxidative damage. This study aimed to identify variability in serum IMA levels in adolescents who smoke. Methods: This case-control study comprised 60 adolescents without any chronic disease. The smoking group was 30 adolescents between the ages of 14 and 17 years who smoked, while the control group was 30 healthy adolescents who did not smoke. Blood samples were collected from all subjects and serum IMA levels and serum nicotine metabolites were determined. Results: The serum IMA levels in the adolescents who smoked were 0.452±0.094 absorbance unit (ABSU), while the control group had ASBU levels of 0.427±0.054. There was no significant difference between the groups in terms of serum IMA levels (p=0.210). There was a significant difference between the control and smoking groups in terms of serum nicotine metabolite levels (p Conclusions: Among adolescents who smoke, serum IMA levels may not be a good marker for oxidative stress.

It is important to follow up the epidemiologic and clinical characteristics of the viral especially rotavirus gastroenteritis to develop strategies for prevention and treatment. Therefore we investigated the rotavirus gastroenteritis in acute diarrhea patinets in our clinic. Stool samples of 263 patients admitted to outpatient clinic or emergency room of COMU Faculty of Medicine Hospital with the symptom of acute diarrhea were screened retrospectively from medical records. Stool samples had been studied with the monoclonal antibody based chromatographic immunoassay (Rota-Adeno Virus Combo Test Device, Ecotest, China). 263 medical records were screened. Rotavirus antigen was positive in 62 cases (23.6%). It was 34.5% in children under 2 years. Rota positivity according to the seasons was as follows: 27.8% in spring, 14.6% in summer, 26.3% in autumn and 21.4% in winter. As a result, acute diarrhea case management should be done for age and seasonal distribution. In these cases unnecessary antibiotic usage should be avoided by rapid diagnostic test when required.

Aim: This study was conducted to investigate whether multivitamin intake can be one of the reasons of childhood obesity. Material and Method: : We carried out a prospective case-control study. The first group included 50 children, as case group who was diagnosed with obesity according to body mass index (BMI) and the second group 50 healty children as control group. Premature babies, children with mental motor reterdation and chronic illness, syndromic children and mothers who couldn%u2019t answer the questions efficiently were excluded. The study was conducted with a questionnaire that was filled out by mothers. Anthropometric measurements including body weight and height were measured by the same researcher (NK). Results: The mean age of the case group was 10,34 ± 3,68 years and 8,88 ± 3,96 years in control group. There were no statistically significant difference between two groups in terms of multivitamin intake during pregnancy so multivitamin intake was not found related with childhood obesity, mode of delivery, gestational age at delivery and birth weight as well. Discussion: In our study; multivitamin supplements had no effect on childhood obesity. Further studies are needed with larger populations to asses it detailed.

The aim of this study was to investigate the relationship between intracranial injury and serum tau protein levels in pediatric patients with minor head trauma (MHT).We included 60 pediatric patients with MHT (Glasgow Coma Scale [GCS], 14-15) and 28 control patients. The patients were divided into 3 groups as follows: those without (group 1) and with (group 2) intracranial lesions shown on cranial computed tomography (CCT) and the control group (group 3).The mean serum tau protein level was 96.06 +/- 70.36 pg/mL in group 1, whereas it was 112.04 +/- 52.66 pg/mL in group 2, with no statistically significant difference between the groups (p = .160). The mean serum tau protein levels between the study groups (group 1 and group 2) and control (38.52 +/- 29.01) were statistically significant (P.001 and P.001, respectively). The GCS score and pathologic condition in CCT were only influential variables on tau protein levels.We found that serum tau protein increased after MHT but did not distinguish between those with and those without intracranial lesions demonstrable on CCT.

Purpose The prevalence of obesity has significantly increased among children and adolescents worldwide and is becoming an important health care problem in parallel with the increased prevalence of obesity pediatric non-alcoholic fatty liver disease. Betatrophin is a newly define hormone that is commonly secreted by liver and plays role in glucose tolerance. This study aimed to investigate the relationship between serum betatrophin levels and non-alcoholic fatty liver disease in obese children. Methods The study included 40 obese children with a body mass index (BMI) above 95th centile, and 35 non-obese subjects with a BMI 3-85th centile, whose age and gender were similar to those of the patient group. For the evaluation of metabolic parameters fasting serum glucose, insulin, alanine aminotransferase, aspartate aminotransferase, lipid profile and serum betatrophin levels were measured. Total cholesterol: high-density lipoprotein cholesterol and low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratios were calculated as “atherogenic indices.” Results Serum betatrophin levels of the obese subjects were similar to that of non-obese subjects (p=0.90). Betatrophin levels were not correlated with the metabolic parameters. Conclusion In the present study, levels of betatrophin are not different between obese and insulin resistant children and non-obese subjects, and they are not correlated with atherogenic indices. To elucidate the exact role of betatrophin in obesity, further studies are required to identify the betatrophin receptor and/or other possible cofactors.

Cocuklarda kronik oksurugun nadir nedenlerinden birisi de bronsta yabanci cisim bulunmasidir. Dokuz yasinda kiz hasta, alti aydir suren oksuruk sikayeti ile basvurdu. Anamnezde hastanin disini yuttugunu daha once basvurdugu merkezlerde ifade etmesine ragmen astim ve pnomoni tanisi aldigi ve ilaclarla sikayetlerinin gecmedigi ve herhangi bir tetkik yapilmadigi ogrenildi. Fizik muayenesinde dinlemekle sagda ekspiryum uzunlugu olup sag hemitoraksta dinlemekle solunum sesi azalmisti. Kan tetkiklerine hafif lokositoz disinda ozellik yoktu. Akciger grafisinde sag bronsial alanda opak gorunumu mevcuttu. Hasta bu bulgularla solunum yolunda yabanci cisim tanisi aldi. Cocuk cerrahisine konsulte edildi ve bronkoskopi yapildi. Sag bronstan bir adet molar dis cikartildi. Oksuruk sikayeti mudahale sonrasinda gerileyen hastanin takiplerinde sikayeti tekrarlamadi. Olgu kronik oksuruk sikayeti ile basvuran okul cagi cocugunda anamnezin, fizik muayenenin ve akciger grafisinin ne kadar onemli oldugunu vurgulamak amaciyla sunulmustur. Anahtar kelimeler: Yabanci cisim, cocuk, dis, kronik oksuruk

To the Editor : A previously healthy 5-y-old boy was admitted to the emergency department with the complaint of leg pain and refusal to walk. Ten days ago he had a period of low-grade fever and fatigue that recovered spontaneously. Twenty-four hours before the admission the leg pain began and then he refused to walk. He was living in a village and had a history of contact with cats. On physical examination, he was well, afebrile and other vital signs were within normal limits. There was no lymphadenopathy or hepatosplenomegaly. Neurologic examination was normal. Extremity examination revealed bilateral calf tenderness on palpation. His gait was stiff-legged and flat-footed; he had difficulty in walking. Complete blood count and basic metabolic profile were normal. Creatine kinase (CK) increased to 809 U/L, three times normal (26–308 U/L). Urinalysis was normal and negative for myoglobin. Serology was performed to establish the etiology. It supported the acute toxoplasma infection and no other agent. His serologic results for T.gondii were as following; IgG Dye test was 6000 (positive ≥16), IgM ELISA was 10 (positive ≥2) and IgG avidity was 1.8 (low ≤20). He completely recovered and could walk independently on the 5th day of follow up. His CK returned to normal (126 U/L) and was diagnosed as benign childhood acute myositis (BCAM) after a toxoplasma infection. Benign childhood acute myositisis is a muscle syndrome that is most commonly seen after a viral infection [1]. The most common presentation of the disease is acute refusal to walk or altered gait during walking. Although the most common etiologic agents are influenza type A and B viruses, the other agents are also reported in the literature [2, 3]. Toxoplasmosis is mostly subclinical or asymptomatic infectious disease in healthy children. Myocarditis and myositis are reported as rare clinical findings [4]. The other clinical findings of BCAM are male predominance and serum CK increase. If the CK levels are too high, patient should be monitored in terms of rhabdomyolysis and renal failure [5]. Duration of symptoms are short and the recovery is spontaneous; therefore, further investigations are unnecessary unless the diagnosis is suspected [3]. In patients with acute gait disturbances if there are no alarming symptoms, BCAM should be considered certainly before unnecessary and invasive investigations. Viral serologic investigations are helpful in supporting the diagnosis.

We aimed to evaluate the relation between QT variables and left ventricular geometry in athletes and obese children.This study included 209 children and adolescents. Thirty-eight of them were obese, 140 were athletes and 31 were normal weighted. Children with history of functional and structural cardiovascular diseases (acquired and congenital), chronic systemic diseases, hypertension, sleep apnea, endocrinological disorders were excluded. All subjects underwent detailed electrocardiographic and echocardiographic examination.QT dispersion was significantly higher in obese children, basketball players, football players and swimmers compared to control group (p0.05, p0.001,0.001 and0.01 respectively). Basketball players had the highest QT dispersion. Left ventricular endsystolic diameter (mm/m2) was higher in footballers, swimmers, wrestlers and tennis players compared to obese subjects. Interventricular septal thickness at diastole was highest in swimmers compared to control group (p0.001) and left ventricular posterior wall thickness was significantly higher in footballers and swimmers compared to healthy subjects (p0.01 and p0.001 respectively). Left ventricular geometry was normal in 84 patients (47.1%), but 34 patients (19.1%) had concentric remodelling, 20 (22.4%) had concentric hypertrophy and 40 (28.6%) had eccentric hypertrophy. No concentric and eccentric hypertrophy was observed in obese subjects. Left ventricle hypertrophy was prominent in dynamic and combined groups but it was not statistically significant (p = 0.204). QT dispersion was statistically higher in obese, dynamic sports and combined sports compared to control group (p0.05, p0.001 and p0.001 respectively).In this study we determined that QT dispersion is elevated in dynamic and combined sports types and obese children.QT dispersion is prolonged in obese and athletes who participate dynamic and combined sports.Introdução: O objetivo deste trabalho foi avaliar a relação entre variáveis QT e geometria do ventrículo esquerdo em atletas e crianças obesas. Material e Métodos: Foram incluídos no estudo 209 crianças e adolescentes. Trinta e oito deles eram obesos, 140 foram atletas e 31 tinham peso normal. Crianças com antecedentes funcionais e estruturais de doenças cardiovasculares (adquiridas e congénitas), doenças sistémicas crónicas, hipertensão arterial, apneia do sono, doenças endocrinológicas foram excluídos. Todos os sujeitos rea-lizaram detalhados exames eletrocardiográficos e ecocardiográficos. Resultados: A dispersão do QT foi significativamente maior em crianças obesas, jogadores de basquete, jogadores de futebol e nadadores, por comparação com o grupo controlo (p0,05, p0,001,0,001 e0,01, respetivamente). Os jogadores de basquetebol tiveram a maior dispersão do QT. O di'metro ventricular esquerdo endosistólico (mm/m2) foi maior nos jogadores, nadadores, lutadores e jogadores de ténis por comparação com indivíduos obesos. A espessura do septo interventricular na diástole foi maior em nadadores por comparação com o grupo controlo (p0,001) e a espessura da parede posterior do ventrículo esquerdo foi significativamente maior nos jogadores e nadadores por comparação a indivíduos saudáveis (p0,01 e p0,001, respetivamente). A geometria do ventrículo esquerdo foi normal em 84 pacientes (47,1%), mas 34 pacientes (19,1%) tinham remodelação concêntrica, 20 (22,4%) apresentaram hipertrofia concêntrica e 40 (28,6%) apresentaram hipertrofia excêntrica. Não foi observada hipertrofia concêntrica e excêntrica em indivíduos obesos. A hipertrofia do ventrículo esquerdo era proeminente nos grupos din'mico e combinado mas a diferença não foi estatisticamente significativa (p = 0,204). A dispersão do QT foi significativamente maior nos obesos e praticantes de desporto din'mico e combinado em relação ao grupo controlo (p0,05, p0,001 e p0,001, respetivamente). Discussão: Neste estudo determinámos que a dispersão do QT é elevada em tipos de desporto din'mico e combinado, e em crianças obesas. Conclusão: A dispersão do QT é prolongada em pacientes obesos e atletas que participam em desporto din'mico e combinado.

Results All of the 237 questionnaire forms that are distributed were gathered back. Ten and half percent of teachers declared that there were students whom have food allergy in their classroom. The most responsible foods in food allergy were reported as egg (19.4%), strawberry (9.4%), chocolate (4.2%) ve tomato (3%). The most commonly observed clinical findings in food allergies were defined as itching (92.4%), rush (76.8%), redness and itching of eyes (65.8), nausea and vomitting (58.2%), abdominal pain (50.6%). It was stated by 41.4% of the teachers that students whom have a life-threatening food reaction are taken to the nearest healthcare unit, 2.5% of the teachers stated that 112 emergency line is called and 0.8% of the teachers stated that parents of the students are notified. The rate of teachers who think that is necessary to give education about food allergy was 95.4%.