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Despite significant advancements in immunization over the last century, vaccine hesitancy is a major threat to world health. Health-related information available from a variety of sources, including new media such as social media platforms, can encourage vaccine hesitancy. The aim of this study is to determine the level of vaccine hesitation among adults, specifically their belief in the advantages of vaccination and their perceptions of vaccine-related dangers in relation to social media addiction and coronavirus disease 2019 (COVID-19) anxiety.Between December 2021 and January 2022, 454 adults participated in an online cross-sectional survey consisting of the social media use disorder scale, the vaccine hesitancy scale, and the coronavirus anxiety scale.The results of the study revealed a strong correlation between social media addiction, vaccine hesitation, and COVID-19 anxiety.Given the potential for misinformation to spread through social media, especially in a situation like a pandemic, the conscious use of social media should be emphasized and anti-addiction measures are required. Novel programs including online interventions should be developed to promote vaccination among social media addicts who have relatively high vaccination hesitancy.

Chest pain is highly prevalent in adolescence, represents a considerable burden for health services, and rarely associated with cardiac disease. Since psychosocial factors are related to chest pain there is a need for exploring the accompanying family functioning and mental health problems in adolescents with non-cardiac chest pain. Here, we assessed these determinants in 68 adolescents with non-cardiac chest pain and 68 age and-sex matched control participants using the 4-item Patient Health Questionnaire-4 for a brief screening for anxiety and depression and the Family APGAR Scale to assess the perception of family functioning. Adolescents with non-cardiac chest pain reported more depression, anxiety and experienced impaired family functioning (p=0.003, p

COVID-19 has affected individuals of all age groups, both physically and mentally. We aimed to determine anxiety and depression in children diagnosed with COVID-19. Fifty children aged 8 to 18 years diagnosed with COVID-19 were included in the study. The children were evaluated the revised Child Anxiety and Depression Scale, STAI form TX-I (state anxiety inventory), and STAI form TX-II (trait anxiety inventory). Child Sleep Habits Questionnaire was applied for one of the parents according to three different periods. The periods were established as before the pandemic, during the illness-quarantine process, and after the quarantine. We observed the highest scores for depression-anxiety and the poorest sleep quality during the quarantine period. The scores for depression-anxiety were lower, and sleep quality scores were higher in the prepandemic period compared with after the quarantine period. Measures should be taken to protect mental health for children with COVID-19.

Aims The influenza virus is an infectious disease with acute respiratory tract infections, caused secondary bacterial infections and death. In this study, we aimed to determine which predictors were associated with the need for high-flow nasal cannula oxygen therapy (HFNC) and transition to intensive care for influenza virus and also to compare single viral pathogens with multiple ones. Methods Inpatients under the age of 5 with influenza virus-related respiratory tract infections between November 2015 and March 2019 were included in the study. Demographic features, comorbidities, symptoms, secondary bacterial infection, need for HFNC and pediatric intensive care unit and respiratory support system, length of hospital stay, polymerase chain reaction tests were recorded. Results A total of 93 patients were included in the study. It was determined that 53.8% of the cases were male and 84.9% were under the age of 2. Comorbidities were present in 50.5% of the cases. Secondary bacterial pneumonia developed in 56.9% of the cases. Patients with secondary bacterial pneumonia had higher PICU need, HFNC need and hospital stay (p = 0.014, p ≤ 0.001 and p ≤ 0.001, respectively). Patients with comorbidity had longer hospital stays and a higher need for HFNC (p ≤ 0.001 and p = 0.001, respectively). Conclusions In this study, it was determined that especially comorbidity and secondary bacterial infection aggravated the clinical treatment of hospitalized patients. Therefore, it was concluded that patients with comorbidity should be followed closely and secondary bacterial pneumonia should be recognized and treated early.

OBJECTIVES: Psychological factors may be the underlying causes in unexplained chest pain (UCP). Chest pain symptom may influence the emotional status and peer relationships of the children and adolescents negatively. However, the number of studies focussing on the aetiology and consequences of the adolescent UCP are still limited. The aim of this study is to investigate the relationships among psychological problems, attachment characteristics, and the UCP in a group of adolescents. METHODS: Seventy-three adolescents with UCP and seventy-one healthy adolescents were included in the study. The adolescents completed the short form of Inventory of Parent and Peer Attachment (s-IPPA), and Strengths and Difficulties Questionnaire (SDQ), while their parents completed the parental form of the SDQ. RESULTS: Contrary to expectations, there was no significant interaction between total parental attachment levels and UCP in the adolescents with UCP. There were significant correlations between the attachment problems and total difficulties score of SDQ. Binary logistic regression analysis revealed that higher emotional and conduct problems and lower pro-social characteristics predict the UCP in adolescents, significantly. CONCLUSIONS: The results suggested that emotional/behavioural problems and lower pro-social behaviour scores are associated with UCP. However, further studies are needed for better understanding about the relationships between the UCP and attachment quality.

Background We investigated the practical use of procalcitonin (PCT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complete blood count (CBC) parameters in distinguishing periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA) attacks from exudative tonsillitis associated with group A streptococcus (GAS) and Epstein–Barre virus (EBV). Methods The study population consisted of cases with exudative tonsillitis who had been subsequently diagnosed as PFAPA, EBV, and GAS tonsillitis through a period of 6 years. We retrieved the CBC, ESR, CRP and PCT data from patients’ medical records. Results Of the patients, 47 (35.6%) had PFAPA, 36 (27.3%) had GAS and 49 (37.1%) had EBV tonsillitis. Median CRP, ESR and PCT values of patients with PFAPA were 78 (17–92) mg/dl, 44 (11–83) mm/h, 0.16 (0.01–1.45) ng/ml, respectively. The CRP and ESR levels were significantly higher in PFAPA and GAS groups compared with the EBV group (p = 0.001). There was no significant difference between the groups regarding the PCT levels. Conclusion The study indicated no benefit of PCT in distinguishing PFAPA from the others. However, we found that CRP, ESR, and CBC parameters could be useful in identifying PFAPA and GAS than EBV tonsillitis.

Objective: Breast milk is considered to be natural, reference nutrition for infants. The American Academy of Pediatrics and World Health Organization recommend that infants should be exclusively breastfed for about 6 months and breasteeding should be continued at least for 12 months as long as both the mother and the infant desire. It is known that mothers who started to work during breastfeeding period have difficulty in continuing breastfeeding due to inconvenient workplace conditions and breastfeeding breaks. Social support, known to have a role in coping with stress, has also been shown to be effective in maintaining breastfeeding. The aim of our study is to evaluate the problems faced by the mothers working in a training and research hospital related to the workplace environment and conditions and their social support. Method: The study group consisted of mothers who had children under three years of age and working in a training and research hospital. Eighteen questions prepared by the researchers, and questions in the Multidimensional Scale of Perceived Social Support were addressed to the mothers participating in the study about their breastfeeding period, return time to their work, breast-feeding permission, and milking, etc. Results: Fifty-one working mothers were reached during the study period. It was seen that 29 (56.9%) working mothers used formula during breastfeeding period. When mothers exclusively breastfed their infants, and those used formula during breastfeeding period were compared, it was seen that the mothers who used formula returned earlier to work (p = 0.036). Conclusion: Study results supported that the period of maternity leave should be longer to avoid using formulas more frequently, and to support exclusive breastfeeding for the first 6 months. It was concluded that employers should provide more suitable conditions for breastfeeding mothers to support breastfeeding.

Objective: The conflicts in the Middle East during the last decade displaced millions of people and led to a serious population movement. Many Syrians have had to leave their country and became a refugee in Turkey. Over the last decade, migration has become one of the most important social, political and public health issues in Turkey. In this study, we aimed to review pediatric refugee cases who were consulted to the Social Service at a Tertiary Hospital. Methods: A retrospective study was performed with refugees admitted to our hospital between January 2012 and December 2018. The socio-demographic data (age, sex, birthplace), medical diagnosis, the reason for the social work consultation and the classification of the social problems were recorded. Results: The number of refugee children that were detected from the medical records was 88; the median age was 10 months (IQR 60.5), and nearly half of them were female. The most frequent diagnosis of the cases obtained from the medical charts was acute respiratory system disorders. The main reason for a social work consultation was poverty. Conclusion: We concluded that professionals working with immigrant children and families should be able to access social and psychological support services. Pediatricians and pediatric societies should work to improve the sensitivity of their respective populations towards migrants and refugees.

Objective: Electrophysiological study (EPS) has been widely used in the diagnosis and treatment of tachycardia. The objective of this study was to determine the anxiety levels in children before EPS procedure. Method: Patients (n=45) who were hospitalized for EPS between March and September of 2019 were included n this cross-sectional study, The patient group consisting of children aged 8-18 years old was compared with age- and sex- matched controls (n=46). We evaluated the severity of anxiety at the time of assessment using the Screen for Child Anxiety Related Emotional Disorders (SCARED) scale. The forms were filled out by both children and their parents. Results: The mean age of the patients in the study group consisting of 23 girls and 22 boys was 13.91±2.84 years. Diagnoses of cases treated due to arrhythmia were as follows: atrioventricular reentrant tachycardia (44.4%), atrioventricular nodal reentrant tachycardia (31%), ventricular tachycardia (11.2%), sinus tachycardia (8.8%), and atrial flutter (4.4%). Anxiety levels were higher in children who were hospitalized for EPS procedure compared to the control group (p

Giriş: Obezite, çocuk ve ergenlerde sıklığı giderek artan ciddi bir sağlık sorunu (MBD) da yol açabilmektedir. Hem obezitenin hem de MBD’nin yaşam kalitesineolumsuz etkiler yaptığı bilinmektedir. Bu çalışmada, obez çocuk ve ergenlerde eşlik eden MBD’nin yaşam kalitesine etkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Çalışmaya, Nisan 2019 - Aralık 2019 tarihleri arasında, üçüncü basamak hastane çocuk sağlığı ve hastalıkları polkliniklerine başvuran 5-17 yaşarası obez çocuk ve adolesanlar alındı. Diğer gruplara benzer yaş ve cinsiyette normal kilolu, solunum yolu enfeksiyonu için kontrole gelen ve Çocuk Nefrolojisipolikliniğine mesane barsak disfonksiyonu bulguları ile başvuran olgular alındı. Mesane Bağırsak Semptom Skorlamasına (MBSS) göre 11 ve üzeri puan alanolgular MBD olarak değerlendirildi. Tüm olgulara, Çocuklar için Yaşam Kalitesi Ölçeği (ÇİYKO) uygulandı.Bulgular: Çalışmaya yaş ortalaması 11,7±3,1 olan 148 obez ve 141 normal kilolu olmak üzere toplam 289 olgu alındı. Obez grupta yaşam kalitesi alt ölçek ve toplamskorları normal ağırlıktaki kontrol grubuna göre anlamlı düşüktü. ÇİYKO’da obez olguları MBSS’ye göre ikiye ayırarak karşılaştırma yaptığımızda, MBSS≥11olan grupta yaşam kalitesi alt ölçek ve toplam skorları istatistiksel olarak anlamlı derecede düşük idi. (p, Introduction: Obesity has become a serious health problem with increasing frequency in children and adolescents. Besides metabolic problems, it can alsocause bladder-bowel dysfunction (BBD). It is known that both obesity and BBD have negative effects on the quality of life. In this study, we aimed to investigatethe effect of BBD on the quality of life in obese children and adolescents.Materials and Methods: Obese children and adolescents aged 5 to 17 years who were admitted to pediatric outpatient clinics between April 2019 and December 2019 were included in the study. The cases with normal weight, similar age and sex to the other groups, who came for respiratory tract infection and presented to the Pediatric Nephrology outpatient clinic with signs of bladder-bowel dysfunction were included. The cases who scored 11 or above according to the Bladder Bowel Symptom Score (BBSS) were considered as BBD. Results: A total of 289 patients, 148 obese and 141 normal weight, with a mean age of 11.7±3.1 years were included in the study. In the obese group, the quality of life subscale and total scores were significantly lower than the control group with normal weight. In obese cases, the quality of life subscale and total scores were significantly lower in the group with BBSS≥11 (p

Objective:The aim of this study was to investigate the peer victimization and anger expression in adolescents with asthma. The relationship between asthma control and psychological features was also examined. Methods:The study was a cross-sectional study with a healthy control group. The sample of the study was composed of 61 adolescents who were previously diagnosed by a physician with asthma of various intensities. Sixty adolescents with no chronic disorders were enrolled as the control group. Peer victimization was examined using the Multidimensional Peer Victimization Scale (MPVS). The State-Trait Anger Expression Inventory (STAXI) was used to assess anger expression styles. Emotional and behavioral symptoms of the adolescents were measured using the Strengths and Difficulties Questionnaire (SDQ). Results:Adolescents with asthma reported more peer victimization in the subscales of physical, social, verbal, attacks on property, and frightening in the MPVS; and having more problems in emotional, social, and peer relations areas in the SDQ (p < .001 for all subscales) compared to the control group. The results were similar between the groups regarding the conduct problems and hyperactive behaviors. The adolescents with asthma reported more anger repression and less anger expression than the control group (p < .001 for both subscales). Conclusions:The results indicated that the adolescents with asthma were subjected to more peer victimization and experienced more difficulties in anger expression than the controls. Based on the findings of this study, we suggest that these psychological factors should be kept in mind during the management of asthma in adolescents.

This study was designed to investigate the frequency of gastroesophageal reflux disease (GERD) in children with functional constipation (FC). It was structured to assess the improvement level in reflux symptoms by measuring the acid reflux in these patients after they had received FC treatment.Ninety-four children who suffered from constipation were evaluated prospectively. Data forms were completed to assess the GERD symptoms in all the cases. Twenty-four-hour pH meter monitoring was performed in 55 of the patients with GERD symptoms. The cases with abnormal acid reflux were treated by conventional therapy for FC. These cases were re-evaluated for GERD symptoms and weekly defecation frequency, and 24-h pH meter monitoring was performed at the end of a 3-month period.An abnormal level of acid reflux was determined in 23 of the 55 cases. After the constipation treatment, a significant improvement was achieved in the acid reflux index and GERD symptoms, whereas the weekly defecation frequency increased.GERD is a frequent problem in children with FC. Treatment of the constipation can improve the reflux symptoms and abnormal acid reflux in these cases. Physicians should bear in mind the co-occurrence of these two prevalent problems for better disease management.

Personality features have been correlated with suicidal behaviors in recent decades. Given its neurobiological background, Cloninger's model of personality, the Temperament and Character Inventory (TCI), may help to identify the maternal and paternal personality dimensions associated with adolescent suicide attempts. The present study is the first that specifically compares the temperament and character profiles of both mothers and fathers of the adolescent suicide attempters with a control group, by considering the influence of demographic and clinical factors. The study group comprised 117 parents of 71 adolescent suicide attempters and 119 parents of 71 age- and gender-matched adolescents without a suicide attempt included as a control group. The TCI and Brief Symptom Inventory (BSI) were applied to the parents in both groups. Logistic regression analysis, which was performed to adjust confounding factors, demonstrated significantly higher scores for harm avoidance among the mothers and lower scores of self-directedness among the fathers of the adolescent suicide attempters. New psychotherapeutic modalities considering the high-risk parental personality traits would be beneficial to support parent-adolescent relationships and may have a preventative effect on adolescent suicide.

INTRODUCTION: Quality of work life affects health service and employee satisfaction is seen as an important factor in ensuring patient satisfaction and sustainability of quality in the health system. Literature studies of doctor's quality of work life in Turkey are limited. In this study, we aimed to give resolution ideas in the light of scientific data. METHODS: Quality of Work Life Scale was applied to the pediatric residents and specialists in İzmir Tepecik Teaching and Research Hospital between 01.03.2018-01.04.2018. RESULTS: During the study period, 49 (90%) specialists and 47 (72.3%) residents were reached in the hospital. When the results were evaluated, it was found that the residents gave more negative feedback on the ‘continuous improvement and progress opportunities’ ve ‘social integration in the organization’ while the specialists gave more negative feedback on the ‘discrimination at work’ subscale. When male and female doctors were compared, it was seen that male employees had more negative scores in the ‘work stress and time pressure’. DISCUSSION AND CONCLUSION: In conclusion, it was seen that the factors affecting the quality of work life of pediatricians could be affected by the seniority and gender. It was discussed that what can be done to improve the quality of work life and the quality of health service delivery.

Aim Acute bronchiolitis is a lower respiratory tract infection caused by viral agents in children aged under two years. Treatment includes hydration, oxygen, nebulized salbutamol, and intravenous steroids. This study aimed to determine the clinically related factors, the effect of viral agents on the clinical picture, and the efficacy of treatment methods in patients admitted with acute bronchiolitis. Material and methods Patients aged under two years of age who were hospitalized with a diagnosis of moderate/severe acute bronchiolitis between March 2015 and March 2019 were included in the study. Demographic data, hospitalization time, body temperature, presence of congenital heart disease, history of atopy, acute-phase reactants, mean platelet volume values, and respiratory virus panel results were recorded. The treatment modalities, length of hospitalization, intensive care hospitalization, and high-flow nasal cannula oxygen therapy (HFNC) were recorded. Results Four hundred twenty-two patients were included in the study. The duration of hospitalization was found to be significantly longer in patients aged under one year and in patients with acyanotic congenital heart disease. A single viral agent was detected in 69 (51.9%) patients. Rhinovirus was detected in 70 patients and RSV was detected in 37. The duration of hospitalization was found to be significantly shorter in patients who received only oxygen and/or intravenous fluid treatment compared with those who received nebulized salbutamol and/or intravenous steroids. In addition, and there was no significant difference between the groups in terms of HFNC and hospitalization in the intensive care unit. Conclusion Rhinovirus was the most common cause of acute bronchiolitis in our study. It was observed that congenital heart disease prolonged the length of hospitalization. In the treatment approaches, it was observed that hydration and oxygen therapy were sufficient treatment methods for the patients, in accordance with the recommendations of the American Academy of Pediatrics, and giving nebulized therapy prolonged the hospitalization period due to the treatment discontinuation steps.

Aim Chest pain is common in adolescence, but there are no established criteria for managing this problem, which is rarely associated with cardiac disease. This study addressed the gaps in the literature by evaluating psychosocial factors that could be associated with medically unexplained chest pain. Methods We consecutively selected 100 patients (68% girls) aged 13-18 who were diagnosed with unexplained chest pain when they presented to the cardiology outpatient clinics of Tepecik Research Hospital, Izmir, Turkey, between 30 September 2015 and 30 June 2018. The controls were 76 age- and sex-matched adolescents (69% girls) aged 13-18 who were undergoing routine cardiology assessments before joining sports clubs. We assessed their health-related quality of life and any depression and physical symptoms. Results Regression analysis showed some adolescents were a number of times more likely to report chest pain. These included those who reported boredom (4.1 times), felt stressed or anxious (2.2) and those who experienced sleep disturbance (2.6), co-morbid headaches (2.0), back pain (3.1) and impaired social functioning (1.2). Conclusion The results indicated a significant association between unexplained chest pain and physical symptoms, depression and impaired emotional and social functioning. These factors warrant further evaluation.

Objective: It was aimed to determine the viral agents in hospitalized infants with acute bronchiolitis and to evaluate the association between clinical course and these agents.

Aim This study aimed to identify differences in the antenatal stressful life events, parenting style, family functioning, depression and anxiety of mothers who have children with breath-holding spells (BHS) compared with controls. Methods This case control study divided 66 children into a group of children with BHS and a control group, with the children's ages ranging between 6 months and 5 years of age. This study explored underlying anxiety and depression in mothers as well as functioning of their families. Socio-demographical data and stressful life events that the mother experienced during pregnancy were analysed. In order to evaluate the effects of family structure, depression and anxiety in mothers on BHS in children, the Family Assessment Device, and both the Parental Attitude Research Instrument and the Beck Depression Inventory as well as the State-Trait Anxiety Inventory were used to assess both groups. Results Exposure to stressful life events during pregnancy (P

AIM: The aim of this cross-sectional study was to determine the prevalence of the self reported health behaviors and differences in these behaviors by gender and grades in high school adolescents in Izmir, Turkey. MATERIAL AND METHODS: A stratified cluster sampling procedure was used for this cross-sectional study. The study sample included 2 296 students attending 22 high schools in Izmir. As a data collection instrument, some questions from the Health Behavior in School-aged Children Study 2009/2010 questionnnaire and questions which were developed by the researchers to understand behaviors of internet use in adolescents were used. Chi-square tests and Cramer's V statistics were used for statistical analyses. RESULTS: Among the high school students, 33.8% experimented smoking, 26.3% smoked cigarette during the 30 days before the survey, 14.9% smoked cigarette regularly during the 30 days before the survey, 54.1% experimented drinking alcohol, 38.4% drunk alcohol during the 30 days before the survey, 31.6% got drunk, 10.9% were adequately physically active, 59.9% watched TV for a long period of time, 72.8% used internet for a long period of time, 48.1% ate breakfast regularly, 36.2% ate adequate amount of fruit, 14.1% ate adequate amount of vegetable, 31.3% ate candies and chocolate very often, 18% drunk soft drink very often, 30.3% were bullied, 29.9% bullied others and 41% involved in a physical fight. CONCLUSIONS: These results showed that "Adolescent friendly health services" should be generalized all over Turkey, physicians should evaluate each adolescent for his/her health behaviors in each visit and implementation of prevention programs which adopt a health promotion perspective is necessary begining from the elementary school. Language: en

Yetim A, Alikasifoglu M, Bas F, Eliacik K, Cig G, Erginoz E, Ercan O, Bundak R. Glycemic control and health behaviors in adolescents with type 1 diabetes. Turk J Pediatr 2018; 60: 244-254. The purpose of this study was to determine the health/health risk behaviors of a group of Turkish adolescents with type 1 diabetes (T1D) to determine the prevalence and explore the exact effect of these behaviors on glycemic control (GC). A total of 210 adolescents (age 12-20 years; diabetes duration > 6 months; no additional comorbidities), completed a self-administered questionnaire (including some questions from Health Behavior in School-aged Children study questionnaire). Subjects were divided into two groups based on the hemoglobin A1c (HbA1c) levels, measured in the last 3 months: good GC (HbA1c < 8%) and poor GC (HbAc1≥8%). Chi-square tests and backward stepwise logistic regression analysis were used in statistical analyses. Of the patients, 57 had good GC and 153 had poor GC. The results of the backward stepwise logistic regression analysis indicated that being overweight and frequent electronic media use were risk factors for poor GC, whereas computer use for homework for long period of time (≥2 hours/day) was found to be a protective factor in terms of GC. Screening adolescents in terms of health/health risk behaviors such as frequent electronic media use, and giving adolescents health responsibilities should be an integral part of the follow-up of these patients, and intervention programs that lead to behavioral changes should be developed.

WOS: 000454206700010, Objective: It was aimed to evaluate the relationship between eating habits and reflux by investigating eating habits in adolescent patients with gastroesophageal reflux disease, and also to assess the interplay between gastroesophageal reflux disease and anxiety. Methods: We included patients between the ages of 12 and 18 diagnosed as gastroesophageal reflux disease in the pediatric gastroenterology outpatient clinic but who had not yet been treated. The control group consisted of age matched adolescents who applied for upper respiratory tract infection. The relationship between eating habits and reflux was assessed with Adolescent Nutrition Checklist, and relationship between gastroesophageal reflux disease and anxiety was assessed with Anxiety Disorder Screening Questionnaire. Results: Seventy adolescents with reflux disease and 67 adolescents as the control group were included in the study. There was no significant difference between the groups regarding the eating habits and anxiety scores. However, it was seen that most of the patients in both groups. had poor eating habits and higher general anxiety score. Conclusion: No relation was found between the gastroesophageal reflux disease, anxiety and eating habits in adolescents. These results suggested that reflux disease should be separated from other gastrointestinal complaints such as abdominal pain which may be psychosomatic. However, there was a quantitative increment in poor eating habits in those with gastroesophageal reflux disease. For this reason there is a need for further studies which investigate the eating habits with a larger sample size of this population.

The aim of this study is to investigate the relationships between attachment characteristics, alexithymia and problematic internet use (PIU) in adolescents. The study was performed on 444 high school students (66% female and 34% male). Internet Addiction Test (IAT), Toronto Alexithymia Scale (TAS-20) and Short Form of the Inventory of Parent and Peer Attachment (s-IPPA) scales were used. The adolescents who scored ≥50 on IAT were considered as the PIU group and50 were considered as control group. There was a moderate positive relationship between TAS-20 and IAT scores (r = .441), and a moderate negative relationship between TAS-20 and s-IPPA scores (r = -.392), and a negative weak relationship between IAT and s-IPPA scores (r = -.208). S-IPPA scores were significantly lower in the PIU group compared to the controls (p .001). TAS-20 scores of the PIU group were significantly higher compared to the controls (p .05). Logistic regression analysis indicated that s-IPPA scores and TAS-20 significantly predict the PIU development (p .05). The results indicate that alexithymia increases the risk of PIU and higher attachment quality is a protective factor for both alexithymia and PIU. These results suggest that it is important to focus on the insecure attachment patterns and alexithymic characteristics when studying adolescents with PIU.

Objective – Uhl’s anomaly, a very rare anomaly with unknown aetiology, is characterized by congenital hypoplasia of the right ventricular myocardium. In this paper, we aim to discuss the clinical findings and the imagining methods. Case report – A six-month-old case was referred us for cardiomegaly. Echocardiography showed a hugely dilated and diffuse hypokinetic right ventricle, magnetic resonance images and cardiac catheterization proved the diagnosis of Uhl’s anomaly. Conclusion – Uhl’s anomaly is a rare cause of cardiomegaly, and echocardiography and cardiac MR images are beneficial in the diagnostic process of this anomaly

Ozet Tum dunyada rotavirus ozellikle 5 yas altindaki cocuklar arasinda onemli bir saglik sorunudur. Rotavirus gastroenteritlerinin sik gorulmesine ragmen, gunumuze kadar az sayida rotavirus gastroenteritine ikincil bakteriyel komplikasyonlar bildirilmistir. Biz bu yazimizda rotavirus gastroenteritine sekonder gelisen Klebsiella oxytoca bakteriyemisi saptadigimiz sut cocugu olgu ile ilgili deneyimimizi paylasmak istedik. (J Pediatr Inf 2015; 9: 134-6) Anahtar kelimeler: Klebsiella oxytoca, rotavirus, gastroenterit, sut cocugu Abstract Rotavirus is an important health issue as a cause of diarrhea worldwide in children, especially under 5 years old. Despite the high frequency of rotavirus gastroenteritis, till date, rotavirus-associated secondary bacterial complications have rarely been reported in children. Herein, we share our experience of a case of acute rotavirus gastroenteritis in an infant complicated by Klebsiella oxytoca bacteremia. (J Pediatr Inf 2015; 9: 134-6)

Chest pain in adolescents is rarely associated with cardiac disease. Adolescents with medically unexplained chest pain usually have high levels of anxiety and depression. Psychological stress may trigger non-cardiac chest pain. This study evaluated risk factors that particularly characterise adolescence, such as major stressful events, in a clinical population. The present study was conducted on 100 adolescents with non-cardiac chest pain and 76 control subjects. Stressful life events were assessed by interviewing patients using a 36-item checklist, along with the Children’s Depression Inventory and Spielberger’s State-Trait Anxiety Inventory for children, in both groups. Certain stressful life events, suicidal thoughts, depression, and anxiety were more commonly observed in adolescents with non-cardiac chest pain compared with the control group. Moreover, binary logistic regression analysis showed that trouble with bullies, school-related problems, and depression may trigger non-cardiac chest pain in adolescents. Non-cardiac chest pain on the surface may point to the underlying psychosocial health problems such as depression, suicidal ideas, or important life events such as academic difficulties or trouble with bullies. The need for a psychosocial evaluation that includes assessment of negative life events and a better management have been discussed in light of the results.

The rapid rise in the global prevalence of obesity suggests that environmental factors may be responsible. The increased use of technology is associated with increased rates of obesity due to declines in physical activity and significant sedentary life style. Internet addiction is also a growing health issue associated with diminished physical activity and poor sleep quality as well as various health problems. The purpose of this study was to determine associations between Internet addiction and adolescent obesity-related problems. In this case–control study, 71 adolescents with obesity were recruited from the outpatient clinic at Tepecik Teaching Hospital and Katip Celebi University Hospital, Department of Pediatric Endocrinology in Izmir, Turkey. The control group consisted of 64 non-obese adolescents that were matched with patients in the study group by age and gender. All subjects completed socio-demographic forms, an Internet addiction scale, the Pediatric Quality of Life Inventory, the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale. Adolescents with obesity were significantly more likely to have Internet addiction (p = 0.002), lower quality of life (p

Objective Mothers of individuals with breath-holding spells (BHS) suffer more often from anxiety and experience more stressors in their everyday life. The purpose of this study was to examine the efficacy of psychoeducational intervention in reducing BHS and coping with these spells. Participants and Methods Mothers who have children with BHS were randomly assigned to one of the two groups: an intervention group receiving psychoeducational therapy in addition to the routine follow-up (n = 31) and a control group who did not receive psychoeducation in their routine follow-up (n = 28). The data collected at the beginning of the study and at the end of 3rd and 6th months about the frequency of the spells per month, maternal anxiety, and depression levels and mothers' perceived self-knowledge about coping BHS of both groups were compared. Results Mothers in psychoeducation group, compared with controls, improved significantly on state anxiety, depression, perceived anticipation anxiety level for BHS of their children and self-knowledge about coping with the spells. Conclusion The intervention program had a positive effect on anxiety-depression levels of the mothers and the frequency of BHS among the children. The possible link between emotional and autonomic dysregulation in children with BHS and maternal mental health were discussed.

Keywords Henoch–Scho¨nlein purpura Terminal ileitis Acute abdomen ChildrenIntroductionHenoch–Scho¨nlein purpura (HSP) is a leukocytoclasticvasculitis characterized by a classic tetrad of nonthromb-ocytopenic palpable purpura, arthritis or arthralgias, andgastrointestinal and renal involvement [1]. HSP most oftenoccurs in children and its incidence between 4 and 6 yearsof age has been reported to be 20.4 cases per 100,000children [2]. Ninety percent of affected individuals are lessthan 10 years of age. Etiology is still obscure but somefactors such as vaccination, some foods, infection, andinsect stings have been thought to play a role in the path-ogenesis of HSP [3, 4].Gastrointestinal system symptoms such as abdominalpain, vomiting, or bleeding are observed in 50–75 % of thepatients [5, 6]. Abdominal pain precedes the rash in12–19 % of cases [6, 7]. Cases of HSP presenting as ter-minal ileitis are rarely encountered in childhood andtherefore this condition makes initial HSP diagnosis diffi-cult. Terminal ileitis has rarely been recognized in patientswith HSP. In the literature, to our knowledge, only nineadult HSP patients have been reported to date [8–11]. Inthis paper, due to its rarity, we present two cases of pedi-atric-onset HSP revealed by gastrointestinal involvement.We also intended to emphasize that the HSP diagnosis canbe more difficult when abdominal pain precedes the cuta-neous rash.Case 1An otherwise healthy 4-year-old boy applied to ouremergency service with complaints of vomiting andabdominal pain over the preceding 4 days. On physicalexamination, the patient was pale and mildly dehydrated.His blood pressure, body temperature, heart rate, andrespiratory rate were 110/60 mmHg, 37.5 C, 94 and26/min, respectively. Abdominal examination revealedtenderness, right lower quadrant pain upon palpation, andrebound tenderness. The rest of his physical examination

Watery diarrhea, hypokalemia and achlorhydria syndrome is a rare cause of chronic secretory diarrhea arising from a vasoactive intestinal peptide releasing tumor. In this article, a 15-month old female patient with watery diarrhea and abdominal distension which lasting four months is presented. In different centers no diagnosis could be made although investigations. The patient was diagnosed with vasoactive intestinal peptide releasing ganglioneuroblastoma localized in the right surrenal gland.

WOS: 000398204700002, PubMed ID: 28266187, This study aimed to investigate the effects of celiac disease (CD) on cardiac function in children by using conventional transthoracic echocardiography (TTE) and tissue Doppler echocardiography (TDE). Forty-nine patients diagnosed with CD were enrolled into the study. Group 1 consisted of 26 (53%) patients who had recently been diagnosed and had not been on glutenfree diet whereas Group 2 consisted of 23 (47%) patients who had been on regular gluten-free diet for at least 10 months. 20 healthy children were enrolled into the study as the control group. The deceleration time (DT) and the left ventricle (LV) isovolumetric relaxation time (IVRT) were significantly shorter in Group 1 compared to Group 2 and the control group (p=0.002, p=0.015). Mitral valve E/E' ratio was significantly lower in Group 1 and 2 when compared to the control group (p

Pollen grains in the atmosphere of Didim, collected using a Durham sampler, were investigated in 2004 and 2005. Weekly pollen grains per square centimetre were calculated. Over a period of 2 years, 17,518 pollen grains/cm(2) belonging to 40 taxa and unidentified pollen grains were recorded. In 2004, 9,879 pollen grains were counted per cm(2), and in 2005 the value was 7,639 per cm(2). The majority of pollen grains investigated were Pinus spp. (45.58%), Cupressaceae/Taxaceae (13.49%), Olea spp. (9.19%), Platanus spp. (7.62%), Gramineae (6.33%), Pistacia spp. (4.34%), Morus spp. (3.81%), Quercus spp. (2.02%), Abies spp. (1.39%), and Plantago spp. (1.11%). During the month of April, 40.46% of total pollen grains were recorded. According to our results, pollen season durations for the dominated pollen grains in Didim were: the 7th-33rd weeks for Pinus spp., nearly the whole year except summer for Cupressaceae/Taxaceae, the 17th-29th weeks for Olea spp., the 10th-24th weeks for Platanus spp., the 8th-46th weeks for Gramineae, the 8th-20th weeks for Pistacia spp., the 11th-21st weeks for Morus spp., the 17th-21st weeks for Quercus spp., the 9th-27th weeks for Abies spp., and the 7th-26th weeks for Plantago spp.

This study compares 2 sampling methods for urine cultures in young infants. We analyzed data on urine samples obtained from 83 infants using 2 sources of urine: suprapubic bladder aspiration (SPA) and bladder catheterization. All specimens were subjected to both urinalysis and culture, and the results compared. Eighty-three infants with positive urine culture results obtained by bladder catheterization were subjected to SPA. Of these, only 24 (28.9%) and 20 (24%) yielded positive urine culture and abnormal urinalysis data, respectively. Samples obtained via catheterization had a high false-positive rate (71.1%). The sensitivity and specificity of urinalysis were 66.7% (95% CI, 44.68% to 84.33%) and 93.22% (95% CI, 83.53% to 98.08%), respectively. In infants younger than 12 months, SPA is the best method to avoid bacterial contamination, showing better results than transurethral catheterization.