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Aim: While many countries around the world have faced similar challenges in pediatric palliative care as COVID-19, there have also been challenges that vary from country to country. In this study, it was aimed to evaluate the difficulties and opinions of families receiving pediatric palliative care in our country during the pandemic process. Materials and Methods: The study is a cross-sectional survey applied to families followed in the pediatric palliative care service between 01.12.2018 and 01.12.2020. In the study, caring parents were asked to share their experiences and opinions in the last year. Results: Of the 175 families followed, 112 were included in the study. In the first year of the pandemic, it was determined that 42% of the families had no change in their lives, 16.1% had psychological problems, 35.7% had social (quarantine and restrictions) problems and 6.3% had economic problems. When the family order and endurance of those who stated that there were significant changes in their lives in the first year of the pandemic were examined, it was found that these individuals were bored with their families and had difficulty staying at home (2.482; p=0.013). Conclusion: The COVID-19 pandemic process in pediatric palliative care has been milder and has a better prognosis than expected. Psychosocial difficulties are the most prominent areas of distress.

BACKGROUND In parallel with the increase in the number of children with life-limiting or life-threatening diseases, the need for and right to pediatric palliative care is also increasing. This study aimed to examine the metabolic diseases, evaluate the symptoms, and review the needs of children who were admitted to the pediatric palliative care service. METHODS Following the approval of the local ethics committee (18/7/2019-107), the computer records of patients hospitalized in the pediatric palliative care service between December 1, 2018 and January 6, 2019 were reviewed retrospectively. Dr Behcet Uz Children's Hospital, Pediatric Palliative Care Center is third center in Turkey. Our pediatric palliative care center has one year of experience. RESULTS In the study period, there were 101 patients who were hospitalized in the pediatric palliative care service. Eighteen patients (19.7%) diagnosed with inborn errors of metabolism were included in the study. The mean age was 3.2 ± 2.1 (0-8) years. Although it could not be shown statistically, the duration of hospitalization of patients with congenital malformation was long. CONCLUSION Pediatric palliative care provides the best care with the control of various symptoms in neurodegenerative congenital metabolic diseases that do not have treatment or treatment, but progressive symptoms cannot be prevented.

Introduction:In recent years, advances in technology and medicine have led to an increase in the number of children with chronic diseases, while reducing the mortality rates of pediatric patients. In this study, it was aimed to evaluate the general characteristics and hospitalizations of pediatric patients receiving health care at home from our hospital.Methods:The study was carried out at the University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children’s Hospital. The cases registered to the home health services unit between 2012 and 2018 were evaluated retrospectively. The demographic features, diseases, medical devices and technological dependence and hospitalization information of these patients were accessed from the hospital registration system. Data were recorded on SPSS program and evaluated statistically.Results:The average age of 124 patients enrolled in the home health services unit was 8.4 (0.6-17.8) years, and 56.5% were male. 71.8% of the patients were diagnosed with a primary neurological disease, especially cerebral palsy. Tracheostomy was present in 31.5% of the patients and 25% were receiving respiratory support by mechanical ventilation. Gastrotomy was present in 12.9% of the patients. While policlinic applications of those with primary neurological disease were significantly higher (p=0.04) compared to the patient group other than neurological disease, hospitalization rates were similar (p>0.05).Conclusion:The neurological group of patients, including pediatric patients with medical devices and technology dependence, is the main group among the patients who are monitored in the home health care unit. Specialized pediatric palliative care services need to be opened and developed in order to meet the medical, psychological and social needs of these patients and to reduce the workload and occupancy of special units such as intensive care.

Thoraco-abdominal duplication cysts are rare congenital anomalies that can accompany vertebral and spinal cord pathologies and occur most frequently in the small intestines. Symptoms such as respiratory distress, dyspnea, tachypnea, cough, hemoptysis, cyanosis, vomiting and dysphagia may develop depending on the location. The cyst has several clinical and radiological dilemmas. We present a rare case of thoraco-abdominal duplication cyst in a 3-month-old male patient presenting with respiratory distress in the neonatal period. Thoraco-abdominal duplications require a high index of suspicion and meticulous clinical management. Thus, patients can be successfully managed without any unnecessary interventions, complications and loss of time.

Introduction:Pediatric palliative care is the highest level of care aiming to improve the quality of life of all children and families with life-limiting and threatening diseases. The knowledge and awareness of pediatricians about pediatric palliative care in our country is not known. The aim of this study was to evaluate the knowledge and awareness level of pediatricians in the field of pediatric palliative care.Methods:The study was planned as a prospective study following the approval of Local Ethics Committee of Dr. Behçet Uz Children’s Hospital. Totally 217 pediatricians answered the questionnaire completely. The data obtained from the survey questions were uploaded to the SPSS program and statistical analysis was performed.Results:Of the 217 pediatricians who participated in the study, 67.3% were women and 59.4% were specialist physicians. 68.7% of the physicians were employed in education and research hospitals and 7.4% in private institutions. It was found that pediatricians heard about pediatric palliative care (p=0.002), but they thought it was less necessary when its effect on quality of life, analgesia and sedation use was questioned.Conclusion:Pediatric palliative care is a new field in our country. It was found that most of the participants heard about pediatric palliative care because they worked in education and research hospital but they did not know the content. In the coming years, we believe that increasing the number of centers and training will increase the knowledge level of pediatricians.

Pediatric palliative care is a top-level care system that focuses on improving the quality of life of the child and family. Quality of life is an expression of individual well-being based on an individual's assessment of their own life. It includes satisfaction in all areas of life, including physical and mental health, environment, and social areas.The study was conducted with the primary caregiver parents of children admitted to the pediatric palliative care service of the Health Science University İzmir Dr. Behçet Uz Child Disease and Surgery Training and Research Hospital. The Turkish version of the World Health Organization Quality of Life WHOQOL-Bref (TR) questionnaire was applied with a personal information form containing demographic data.Eighty-four patients were hospitalized in the specified period, and 67 primary caregiver parents agreed to participate in the study. Total scores evaluated by WHOQOL-Bref (TR); the physical domain was 19.95 ± 3.30, the mental domain was 19.95 ± 3.18, the social domain was 10.11 ± 2.40, and surrounding area was 16.38 ± 2.82. The physical and psychological subgroups' scores were statistically significantly higher in primary caregiver parents with good social support (P.005).It has been determined that in order to increase the quality of life and care of children with life-limiting and/or threatening diseases, the quality of life of primary caregiver parents should be increased, and "social support" procurement, which has the most important effect on the quality of life, is an important need.

Crohn hastalığı süt çocukluğu döneminde sık görülmez. Çocukluk yaş grubunda olgular genelde okul çağı ve adolesan yaşlarda görülür. Kronik ishal, gelişme geriliği, rektal kanama, karın ağrısı, ateş, oral ve perianal lezyonların varlığı, yüksek akut faz reaktanlari Crohn hastalığını düşündüren bulgulardır. Öte yandan, amip tedavisine karşın iyileşmeyen amebiyazis olgularında, bu durumun inflamatuvar barsak hastalığına bağlı olabileceği akılda tutulmalı, tedaviye dirençli amip enfeksiyonlarında ayırıcı tanıda inflamatuvar barsak hastalıkları düşünülmeli ve araştırılmalıdır., Crohn disease is rare in infancy and early childhood. It is reported that patients with Crohn disease are usually diagnosed during school age and adolescence periods. Chronic diarrhea, failure to thrive, rectal bleeding, abdominal pain, fever, oral and perianal lesions and high levels of acute phase reactants suggest Crohn disease. Inflamatuar bowel diseases should be considered in cases with intractable amoebiasis. Inflammatory bowel diseases should be taken into account for differential diagnosis in cases with amoebiasis resistant to therapy.