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Advances in technology in recent years increased the long-term survival rate of patients with chronic respiratory failure. As a result, the number of patients receiving long-term home mechanical ventilation (LTHV) support is increasing worldwide. The most important step in the management of patients with home mechanical ventilation (HMV) is to ensure adequate oxygenation and ventilation. Successful care at home requires the presence of trained caregivers and accessibility to medical devices and a care team. The aims of this study were, to describe the characteristics of children on LTHV in Istanbul, to compare the patients receiving non-invasive ventilation (NIV) and invasive ventilation, and to evaluate the frequency and risk factors of hospital admission in this population.

Having a child with a chronic illness is a source of stress for the whole family, especially the primary caregiver. The aim of this study was to evaluate the associations between caregiver burden and both the caregiver's and child's psychological symptoms in a cohort of children with systemic lupus erythematosus (SLE).Thirty-four patients (aged 9-18 years) with childhood-onset SLE and their caregivers participated in this study. The control group was composed of healthy children and their caregivers. Questionnaires were used to evaluate caregiver burden and the psychological status of parents and children and adolescents with and without SLE.No significant difference was found between the study and control groups for caregiver burden, anxiety and depression in parents, and psychological status in children. Caregiver burden was positively correlated with parent's depression, anxiety, and behavioral and peer problems of the children, and it was negatively correlated with the children's prosocial behaviors. According to regression analyses, the parents' depression and children's peer relationship had a positive effect on caregiver burden scores.Physicians should be aware of the presence of psychological symptoms in patients with childhood-onset SLE and their caregivers because it can affect caregiver burden and the caregiver's psychological state. Key points •Caregiver burden was positively correlated with parent's depression and anxiety. •Caregiver burden was positively correlated with children's behavioral and peer problems. •Caregiver burden was negatively correlated with child's prosocial behaviors.

Brucellosis is one of the most common zoonosis worldwide. It is still endemic in many regions of the world. A 6-year-old female was admitted to the emergency department (ED) due to a sudden change in consciousness, urinary incontinence, vomiting, and difficulty in walking. Neurological examination demonstrated abducens nerve paralysis, mild-to-moderate motor deficit in hemiparesis in the left arm. Brain magnetic resonance imaging showed a hemorrhagic focus at the right frontal lobe and thrombosis in the superior sagittal sinus of the brain. The diagnosis of neurobrucellosis was confirmed by identifying Brucella spp. in the blood culture on the day 6 of pediatric intensive care unit admission; thus, trimethoprim-sulfamethoxazole and rifampicin, and ceftriaxone were promptly initiated. Despite neuroprotective management and acetazolamide, the patient's neurological problems and high intracranial pressure (ICP) persisted. An external ventricular drainage tube and a Codman ICP monitor were placed to be on the consent vigilance of the patient's neurological condition. The patient's ICP continued to increase despite the current treatment regimen; therefore, a decompressive bitemporal craniectomy was performed. The ICP level of the patient returned to its normal range immediately after the craniectomy. The patient did not have any notable neurologic sequelae at the first-year follow-up. Neurobrucellosis is a rare complication of systemic brucellosis and may present as meningitis, encephalitis, myelitis, radiculitis, and/or neuritis. Herein, we describe a six-year-old girl with brucellosis complicated with cerebral vein thrombosis. This case illustrates the need for close monitoring of patients with unexplained neurological signs or symptoms for brucellosis in endemic areas.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) accounts for 0.023% of all cases reported in pediatric patients. According to literature, only a handful of ALCAPA patients are able to reach adulthood. Clinical manifestations of ALCAPA range from fatigue during exercise to sudden death in adulthood. Herein, we described a 12-year-old symptomatic patient with ALCAPA who had severe chest pain after using salbutamol treatment for presumed asthma. ALCAPA is one of the curable versions of myocardial ischemia and infarction in childhood. Due to clinical findings in conjunction with electrocardiogram and echocardiography, a computed tomography scan with coronary angiography was performed and the diagnosis of ALCAPA was confirmed. We presented this case because ALCAPA-related myocardial ischemia and infarction in children are rare with only sporadic cases reported. This case illustrated the need for close monitoring and surgery as the best treatment for ALCAPA associated with myocardial infarction.

Introduction: Subglottic stenosis (SGS) is one of the most common causes of upper airway obstruction among children. The most important factor that affects the development of SGS is endotracheal intubation. In this study, patients diagnosed with post-intubation subglottic stenosis were examined, and the factors contributing to the development of stenosis, as well as the demographic features of the patients, are discussed. Methods: This retrospective study included 104 patients admitted to Bezmialem Vakif University. Bronchoscopy performed due to post-intubation respiratory symptoms between the 2011 and 2016. The demographic features of 50 patients with SGS and 54 patients without SGS, the number and duration of intubations, and the history of hypoxia and infection were evaluated. Results: The mean age of the patients with SGS detected by bronchoscopy was 12.6 months. The female/male ratio was 0.9. The mean duration of intubation was 27.5 days in the patients with SGS, whereas it was 9.9 days in the patients without SGS. In the SGS group, the mean leukocyte count was 16988/mm3 (min-max: 5600 37800/mm3) and the mean CRP value was 15,1 (min-max: 0.02-70), whereas in the patients without SGS had a mean leukocyte count of 13558/mm3 (min-max:2400-36120/mm3) and a mean CRP value of 7,3 (min-max:0.02-50). An intake of oxygen at a concentration of 30% and over during intubation was required in 31 patients with SGS (62%) and in 14 patients without SGS (26%) to maintain the oxygen saturation level at 95% and above. Conclusion: The duration of intubation, increased levels of leukocytes and CRP, and hypoxia were important factors for the development of SGS in intubated patients.

Introduction: The diagnosis of childhood tuberculosis is difficult and most of the patients are diagnosed clinically. The objective of this study is to reveal the diagnostic and therapeutic components of childhood pulmonary tuberculosis and to analyze the changes that occurred in our country over the years. Methodology: All patients diagnosed with tuberculosis between 2006 and 2016 were included. Demographic characteristics, diagnostic and treatment outcomes were recorded and patients were followed up prospectively. Results: A total of 492 patients were included in the study. 97% had Bacillus Calmette-Guerin vaccine, 36% were diagnosed with microbiologically-confirmed tuberculosis and 64% were diagnosed with clinically-proven tuberculosis. 94% of the patients had symptoms consistent with tuberculosis, all patients had radiologic findings, 74% had a history of tuberculosis contact and 63% had tuberculin skin test positivity. The diagnoses included primary tuberculosis in 62%, secondary tuberculosis in 21%, progressive primary tuberculosis in 13% and miliary tuberculosis in 4%. 48% of the patients received a treatment regimen containing three drugs as the initial treatment, and drug-related side effects developed in 12%. Isoniazid resistance was detected in 13% of the patients and rifampicin resistance was detected in 8%. None of the patients died due to tuberculosis. In the last 50 years in Turkey, the rates of Bacillus Calmette-Guerin vaccination and diagnosis of tuberculosis cases have increased and the mortality rates have decreased over the years. Conclusions: Our study is one of the few prospective studies and revealed the differences between the recent data and the past 50 years in childhood tuberculosis in Turkey.

Infective endocarditis (IE) is an uncommon infection in children. The recommended treatment for native valve endocarditis secondary to methicillin-susceptible Staphylococcus aureus infection is antistaphylococcal penicillins such as nafcillin or oxacillin. If the initial therapy fails in IE, it can lead to catastrophic results. Nowadays, daptomycin is the best alternative antimicrobial agent to treat children with severe infections, when standard antimicrobial therapy does not yield a result. Herein, in this article, we described a case of a 16-year-old boy who had aortic valve S. aureus endocarditis with septic embolization and stroke. The patient was successfully treated only with daptomycin as well as surgical therapy in the early phase of the infection.

Background Tracheostomy-related morbidity and mortality mainly occur due to decannulation, misplacement, or obstruction of the tube. A standardized training can improve the skills and confidence of the caregivers in tracheostomy care (TC). Objective Our primary aim was to evaluate the efficiency of standardized training program on the knowledge and skills (changing-suctioning the tracheostomy tube) of the participants regarding TC. Materials and Methods Sixty-five caregivers of children with tracheostomy were included. First, participants were evaluated with written test about TC and participated in the practical tests. Then, they were asked to participate in a standardized training session, including theoretical and practical parts. Baseline and postintervention assessments were compared through written and practical tests conducted on the same day. Results A significant improvement was observed in the written test score after the training. The median number of correct answers of the written test including 23 questions increased 26%, from 12 to 18 (p < .001). The median number of correct steps in tracheostomy tube change (from 9 to 16 correct steps out of 16 steps, 44% increase) and suctioning the tracheostomy tube (from 9 to 17 correct steps out of 18 steps, 44% increase) also improved significantly after the training (p < .001, for both). Conclusion Theoretical courses and practical hands-on-training (HOT) courses are highly effective in improving the practices in TC. A standardized training program including HOT should be implemented before discharge from the hospital. Still there is a need to assess the impact of the program on tracheostomy-related complications, morbidity, and mortality in the long term.

Cardiogenic pulmonary edema (CPE) is a rare clinical condition of acute rheumatic fever (ARF) in the early stage. Generally, CPE can be convalesced by steroid and anticongestive treatment. Herein, we describe a case of a 14-year-old boy with ARF presenting with bilateral pulmonary edema secondary to acute mitral and aortic insufficiency. In this case, the pulmonary edema of ARF was successfully managed by combined surgical replacements of both valves.

Amaç: Bu çalışmanın amacı, vezikoüreteral reflü yönünden ileri tetkik planlananhastalarda voiding sistoüretrogram ve voidingürosonografi yöntemlerinin reflünün ortaya konmasındaki başarı oranlarınındeğerlendirilmesidir.Gereç ve Yöntemler: Çalışmayavezikoüreteral reflü için araştırılan ve voiding sistoüretrogram tetkikiplanlanan 48 hasta alındı. Hastalar yaş, cinsiyet ve voiding sistoüretrogramplanına neden olan nefrolojik problemler için değerlendirildi. Bulgular: Çalışmadaki 48 hastanın 34’ü kız ve 14’üerkekti. 48 hastanın 18’inde vezikoüreteral reflü saptandı. Tüm böbrek-üreterüniteleri vezikoüreteral reflü açısından değerlendirildi ve voidingsistoüretrogram ile %91,3, voiding ürosonografi ile %73,9 böbrek-üreterünitesinde vezikoüreteral reflü tespit edildi. Kullanılan iki yöntemintutarlılık oranı %73,6 olarak saptandı ve her iki yöntem arasında vezikoüreteralreflü saptanması açısından istatistiksel olarak anlamlı fark olmadığı gösterildi.Grade I vezikoüreteral reflü olguları çalışmaya dahil edilmediğinde ise her ikiyöntemin tutarlılık oranı %87,6’ya kadar yükseldi. Vezikoüreteral reflüsaptanması açısından her iki yöntem arasında istatistiksel olarak farkın anlamlıolmadığı tespit edildi.Sonuç: Çalışmamızda vezikoüreteral reflü tanısındavoiding ürosonografinin, voiding sistoüretrogram kadar başarılı olduğusaptanmıştır. voiding ürosonografi özellikle antireflü cerrahinindeğerlendirilmesinde, izlemdeki yüksek grade vezikoüreteral reflü hastalarınıntakibinde, voiding sistoüretrogram uygulanmasının kontrendike olduğu kümülatifradyasyon yükü riskinde ve yüksek risk gruplarında ve primer olarak kızçocuklarında tarama prosedürü olarak alternatif bir teknik olarak tercihedilebilir., Purpose: The goal of the study was to investigate thesuccess rates of voiding cystourethrogram and voiding urosonography in patientswho were scheduled for further investigation vesicoureteral reflux.Material and Methods: This study included 48 patients who wereevaluated for vesicoureteral reflux and planned for voiding cystourethrogram.The patients were evaluated for gender, age and nephrologic problems whichcausing for plan voiding. Results: Of the 48 patients in the study, 34 were femaleand 14 were male. Vesicoureteral reflux was detected in 18 of 48 patients. Allrenal-ureter units were evaluated for vesicoureteral reflux and 91.3% withvoiding cystourethrogram and 73.9% with voidingurosonography were detected in the renal -ureter unit. The coherence rateof both methods was found to be 73.6% and it was shown that there was nostatistically significant difference between the two methods for the detectionof vesicoureteral reflux. When the cases of grade I vesicoureteral reflux wereexcluded from the study, the consistency rate of both methods increased to87.6%. There was no statistically significant difference between the methodsfor detecting vesicoureteral reflux in renal ureter units (p=0.146).Conclusion: Voiding urosonography can be used as analternative radiation-free imaging method for selected cases.

Background and objective This study aims to evaluate clinical and radiological findings and treatment outcomes of the patients with PIBO. Methods One hundred fourteen children were enrolled. Initial demographic and clinical findings were evaluated. Pre- and post-treatment clinical and radiological findings were compared. Results The median age of the patients at initial pulmonary injury was 7,2 months, the median age at diagnosis was 17.5 months. Persistent wheezing was the most common complaint. Thirty-five patients had mechanical ventilation history. 82,5% of patients had clinical improvement. Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT improved significantly with treatment. Post-treatment Bhalla scores decreased from 8.3 to 6.5 (p= 0,001). Improvement was observed in radiological and clinical findings after treatment. Conclusions This study is one of the largest studies in the literature and one of the few studies that evaluate clinical and radiological outcomes of patients with PIBO.

Introduction: The pediatric tracheostomy related mortality mostly occurs due to accidental decannulation and cannula obstruction. The caregivers may be discharged with inadequate knowledge. Aims and objectives: Simulation training can highlight skills regarding tracheostomy care. Our aim is to investigate if a standardized hands-on-training improves knowledge and skills among caregivers. Methods: Before the traning, we applied a pretest to caregivers in order to assess their knowledge and current practises. Skills were evaluated by two simulation scenarios in a patient model: cannula change and aspiration. After one hour theoretical and practical hands-on training, the same post-test was applied, skills were reevaluated regarding cannula change and aspiration with practical tests. Results: The multicenter study included 65 caregivers of patients with tracheostomy. The median score of the theoretical test including 23 questions improved from 12 to 18 (p

Background. Fulminant myocarditis (FM) is a potentially lethal condition in children due to rapid progressive hemodynamic instability and cardiogenic shock. Patients with FM might show different clinical manifestations on emergency department admission. Case. Herein, we describe the case of a 12-year-old girl who was admitted to our institution’s emergency department due to complaints of abdominal pain and incessant vomiting. However, we detected an early onset of atrial fibrillation (AF) accompanied by FM. The patient’s condition of AF and severe hemodynamic disorder was successfully treated in our institution’s pediatric intensive care unit. Conclusion. To the best of our knowledge, this is the first report of the co-occurrence of FM and AF successfully treated in childhood. This case report will serve as a guide for the treatment of cases with FM accompanied by AF.

Sulfur fumigation has come to replace traditional sun drying methods for drying fruits over the years around the world as it is a cheaper and faster method because of its pesticidal and anti-bacterial properties. We report the case of an 11-year-old boy with acquired severe biphasic stridor who was exposed to extremely high concentrations of sulfur dioxide (SO2) during apricot sulfurization processes with his mother. The patient's bronchoscopy revealed severe glottic and subglottic damage. Exposure to SO2 is a health risk, particularly for individuals who are sulfide-sensitive, especially in childhood. The pulmonary epithelium may be directly injured by inhaled toxic substances at various levels of the respiratory system. To the best of our knowledge, this is the first case reported of acquired airway damage associated with sulfurization in a pediatric patient without a known history of any respiratory disease or symptoms.

Objective: This study aims to evaluate clinical and radiological findings and treatment outcomes of the patients with PIBO. Methods: One hundred fourteen children were enrolled. Initial demographic and clinical findings were evaluated. Pre- and post-treatment symptoms, radiological findings and scores, the number of admissions to the hospital and PICU were compared. Results: Seventy-three patients were male. The median age of the patients at initial pulmonary injury was 7.2 months, the median age at diagnosis was 17.5 months and the median interval from initial injury to diagnosis was 8.5 months. Thirty-five patients had mechanical ventilation history. Persistent wheezing was the most common complaints. The most common radiological findings were peribronchial thickening and air-trapping. Sixty-eight patients were treated with inhaled corticosteroid (IC), systemic corticosteroid (SC) and azithromycin (AZT) combination. 25 patients were treated with only IC, 14 with IC and AZT, and 7 with IC and SC. 82,5% of patients had clinical improvement. Chronic respiratory failure occurred in 11 patients, and three patients died. Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT improved significantly. Bhalla scores decreased from 8.3 to 6.5 (p= 0,001). IC, SC and AZT combination was effective than the other treatments. Conclusions: This study is one of the largest studies in the literature and one of the few studies that evaluate clinical and radiological outcomes. We found that IC, AZT and SC combination is clinically and radiologically effective in patients with PIBO.

Double aortic arch (DAA) is a common form of complete vascular ring. The condition leads to airway obstruction and compression of the esophagus. A balanced type of DAA is an extremely rare anomaly. The anatomical aberration cannot be easily distinguished by transthoracic echocardiography when an infant has chronic respiratory distress. Herein we presented a case of an 11-month-old infant who had chronic respiratory distress and a balanced type of DAA.

Introduction : Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. Vitamin D is a liposoluble vitamin synthesized mainly in the skin. Vitamin D has several effects on the skin. Aim : To assess the serum level of vitamin D in children with AD and determine its relation to AD severity. Material and methods : Sixty patients with AD were enrolled in the study. We evaluated disease severity using the SCORing Atopic Dermatitis (SCORAD) index. The control group consisted of 37 healthy subjects. Results : The mean serum concentration of 25(OH)D3 in patients with AD was not statistically different from control subjects (p = 0.065). The vitamin D level was significantly lower in moderate and severe AD compared with mild AD, and this difference was statistically significant (p = 0.001 and p = 0.004). Vitamin D showed a negative correlation with serum total IgE levels (p = 0.007). There was no significant correlation between total IgE levels and SCORAD scores (p = 0.089). Conclusions : This study suggests that a low serum vitamin D level is inversely associated with severity of AD in children. Vitamin D has not been included in the routine treatment of AD because of the conflicting results of various studies. Thus, there is a need for more detailed and prospective studies.

There is no documentation about the association between peer victimization, psychological status, and quality of life (QOL) in children and adolescents with systemic lupus erythematosus (SLE). The aim of this study was to evaluate the association between peer victimization, psychological symptoms, and QOL in a cohort of children and adolescents with SLE. Forty-one patients (aged 9-18 years) participated in this study. The control group (n = 49) was composed of healthy children and adolescents from local community. Questionnaires were used to evaluate the peer victimization, psychological status, and QOL of children and adolescents with and without SLE. No significant difference was found between the study and control groups for peer victimization, depression, state and trait anxiety, and QOL scores. The peer victimization, depression, anxiety, and self-esteem scores were negatively correlated with psychosocial and total subscale scores of QOL in the study group. According to regression analyses, trait anxiety had a negative predictive effect on the physical health domain scores of QOL, whereas trait anxiety and peer victimization had a negative effect on the psychosocial domain and total scores of QOL in the SLE patients. This study suggests that trait anxiety and peer victimization are risk factors for poor QOL in adolescents with SLE.

Streptococcus anginosus can be frequently isolated from brain abscesses, but is a rare cause of the liver, lung, and deep tissue abscesses. In this report, we present a patient with subdural empyema, brain abscess, and superior sagittal cerebral venous thrombosis as complications of rhinosinusitis whose purulent empyema sample yielded S. anginosus. A 13-year-old female patient was referred to our pediatric intensive care unit with altered mental status, aphasia, and behavioral change. On a brain computed tomography scan, subdural empyema extending from the left frontal sinus to the frontal interhemispheric area and left hemispheric dura was detected. Intravenous ceftriaxone, vancomycin, and metronidazole treatments were started. Subdural empyema was surgically drained. Postoperative brain magnetic resonance venography imaging showed superior sagittal sinus thrombosis. Cultures obtained from purulent empyema sample revealed S. anginosus. On the third day of hospitalization, a brain computed tomography scan showed brain edema, especially in the left hemisphere and significantly increased subdural empyema that had been previously drained. She was reoperated and decompressive craniectomy was performed. On the fifth day, partial epileptic seizures occurred. Brain magnetic resonance imaging showed a brain abscess on the interhemispheric area. The magnetic resonance imaging findings of abscess formation improved on 30th day and she was discharged on the 45th day after the completion of antibiotic therapy.

We report a 13-year-old boy who (initially) had symptoms of toxic shock-like syndrome and mumps. Then, the patient was hospitalized in the pediatric intensive care unit (PICU) because of his ongoing hemodynamic instability (low blood pressure of 70/30 mm Hg and capillary refill time of > 4 seconds). During his stay in the PICU, the patient was treated with fluid resuscitation and vasoactive infusion and at the same time was diagnosed with Kawasaki disease shock syndrome (KDSS), when giant right coronary artery aneurysms were detected on echocardiographic examination. This case illustrates the risk of KDSS in patient who carries both parotitis and toxic shock-like syndrome. The clinicians should be cautious about detecting any types of coronary artery aneurysms in such patients. This is the first case of KDSS associated with parotitis reported in the literature.

Purpose We aimed to evaluate the autonomic nervous system activity in children with overactive bladder (OAB) syndrome. Methods Included in the study were 40 children with overactive bladder and 28 healthy controls. Autonomic tests were performed on all participants, including heart rate interval variation (RRIV), heart rate response to valsalva maneuver, and sympathetic skin response (SSR). Results Mean valsalva rates in the overactive bladder and control groups were 1.53 ± 0.29 and 1.30 ± 0.18, respectively, a statistically significant difference (P 0.05). Conclusions This study demonstrated a parasympathetic hyperactivity in children with OAB, results suggesting a dysfunction in their autonomic nervous systems. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.

The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders.The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study.The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p = 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p = 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r = -0.263, p 0.001) and duration of pacifier use (r = -0.249, p = 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (β = 0.88, p = 0.006) and bottle-feeding (β = 1.02, p = 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder.Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.

OTO, ARZU/0000-0003-0229-2759; Sevketoglu, Esra/0000-0002-8330-2877, WOS: 000496521400006, PubMed: 31435144, Objectives:To analyze the course of seasonal viral infections of respiratory tract in patients hospitalized in pediatric intensive care units (PICU) of 16 centers in Turkey. Materials and methods: It is a retrospective, observational, and multicenter study conducted in 16 tertiary PICUs in Turkey includes a total of 302 children with viral cause in the nasal swab which required PICU admission with no interventions. Results: Median age of patients was 12 months. Respiratory syncytial virus (RSV) was more common in patients over one year of age whereas influenza, human Bocavirus in patients above a year of age was more common (p = 60 mm Hg. Conclusion: Our findings demonstrate that patients with neurological symptoms, tachycardia, hypoxia, hypotension, acidosis, impaired liver, and renal function at the time of admission exhibit more severe mortal progressions. Presence of acidosis and multiorgan failure was found to be predictor for mortality. Knowledge of clinical presentation and age-related variations among seasonal viruses may give a clue about severe course and prognosis. By presenting the analyzed data of 302 PICU admissions, current study reveals severity of viral respiratory tract infections and release tips for handling them.

Amaç: İmmünglobülin A eksikliği ile atopik hastalıklar arasındaki ilişkiyi incelemek.Materyal ve metod: Atopik hastalık tanılı 68’i erkek, 35’i kız toplam 103 hastanın dosyaları geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, atopik hastalık tanıları, eşlik eden hastalıkları, ailede atopi öyküsü, gaytada parazit testi, deri prick testi sonuçları, immünglobülin A, G, M, E ve eozinofil düzeyleri kaydedildi. İmmünglobülin düzeyleri nephelometrik yöntemle ölçüldü. Üç hasta, IgM ve/veya IgG düzeyleri yaşa göre düşük bulunduğu için çalışma dışı bırakıldı.Bulgular: Atopik hastalık tanısıyla takip edilen hastaların 7’sinde IgA düzeyleri yaşa göre düşük bulunurken sadece 1 hastada 5mg/dl’nin altında bulundu. Selektif IgA eksikliği sıklığı hasta grubumuzda %1 olarak hesaplandı. IgA eksikliği bulunan hastaların tümü erkekti ve cinsiyetler arasındaki fark istatistiksel olarak anlamlı bulundu (p꞊0.043). IgA düzeyi düşük olanlarla normal olanlar arasında ailede atopi öyküsü açısından fark saptanmadı (p꞊0.34). IgA eksikliği bulunan hastaların tümünde astım öyküsü vardı ancak diğer atopik hastalıklar yoktu. IgA eksikliği bulunanlar ile normal sınırlarda olan atopik hastaların eozinofil ve IgE düzeyleri arasında fark saptanmadı. Sonuç: Atopik hastalarda IgA eksikliği sıklığının genel popülasyonda görülen Selektif IgA eksikliği sıklığından farklı olmadığını, bu nedenle de atopik hastalıklar ile IgA eksikiği arasında doğrudan bir ilişki olmadığını düşünüyoruz.

Background: The aim of this study was to determine if the skin temperature of febrile children is affected by the child's exposure to cold outdoor temperatures immediately prior to the taking of that temperature. Methods: A total of 150 febrile and non-febrile children (aged 3-10 years) who had walked to the hospital's pediatric emergency department and were thus exposed to outside cold weather were enrolled in the study. Using infrared thermometry, forehead and chest skin temperatures were simultaneously measured every 2 min during the first 14 min after presentation. Temperatures were recorded and differences between the two measurements were calculated. Results: By the fifth evaluation (10 min from the first reading), skin temperatures from forehead and chest had equalized. Conclusion: Determination of fever from the body parts that had been exposed to cold environmental conditions may cause contradictory results if taken while the child is still chilled from exposure to the cold. For accuracy, children should be acclimated to the indoor temperature before taking body temperature readings. Acclimation takes at least 10 min after coming in from cold weather outside.

Hydrocephalus represents a diverse group of conditions that are characterized with dilatation of the ventricular system and increased cerebrospinal fluid pressure Ventriculo peritoneal shunt placement is a commonly used treatment method for hydrocephalus for diverting the cerebrospinal fluid into the peritoneal cavity The most common complication of ventriculo peritoneal shunt is dysfunction of the shunt mainly due to catheter obstruction or infection Spontaneous bowel perforation is a rare complication of ventriculoperitoneal shunt This article aims to discuss ventriculo peritoneal shunt complications and the significance of colon perforation among these complications by presenting two cases of anal protrusion of ventriculoperitoneal shunt catheter that is inserted in order to reduce the hydrocephalus detected in the neonatal period Turk Arch Ped 2013; 48: 255 258

We report three paediatric cases of Kawasaki disease (KD). Erythema multiforme (EM) was the presenting cutaneous feature in two patients, with young age (43 days old), macular rash and meningitis in the third patient. Diagnosis of KD was difficult due either to initial misdiagnosis of drug eruption, incomplete presentation, or the young age of the patient. Clinicians should be aware of these cutaneous presentations to prevent KD complications.

Amac: Bilimsel calismalar dikkat eksikligi hiperaktivite bozuklugu (DEHB) ve oksidatif stres arasindaki iliski ile ilgili farkli ve tutarsiz veriler sunmaktadir. Bu calismada DEHB hastalarinda tiyol/ disulfit homeostazi gibi yeni bir oksidatif stres markirini incelemek ve sonuclari saglikli kontrol grubu ile karsilastirmak amaclanmistir. Gerec ve Yontemler: Calismaya psikotrop ilac kullanim oykusu olmayan 6–17 yas araliginda ve DEHB tanili 47 cocuk (35 erkek ve 12 kiz) ve yas ve cinsiyet olarak benzer 41 saglikli cocuk (28 erkek, 13 kiz) dâhil edilmistir. Total antioksidan seviyesi (TAS), total oksidan seviyesi (TOS), oksidatif stres indeksi (OSI), miyeloperoksidaz (MPO) ve dinamik tiyol/disulfit homeostazi gibi oksidatif stres parametreleri bu iki grup arasinda karsilastirilmistir. Es tani durumu Okul Cagi Cocuklari icin Duygulanim Bozukluklari ve Sizofreni Gorusme Cizelgesi-Simdi ve Yasam Boyu Sekli-Turkce Uyarlamasi (CDSG-SY-T) kullanilarak degerlendirilmistir. Bulgular: TOS, OSI ve MPO degerleri DEHB grubunda anlamli olarak dusuk bulunmustur (sirasiyla p=0,001; p=0,022; p=0,007). Dikkat-eksikligi-baskin-tip DEHB grubunda TAS (p=0.014) ve TOS (p=0.01) degerleri kombine alt tipe oranla anlamli olarak daha dusuk cikmistir. Oksidatif stres indeksi (OSI), hem hasta ve kontrol gruplarinda hem de iki grup birlikte degerlendirildiginde artan yas ile birlikte istatistiksel olarak anlamli bir azalma gostermistir (sirasiyla r= - 0.376, p=0.009; r= - 0.479, p= 0.002 ve r= - 0.367, p

Objective: We aimed to evaluate the reliability of Turkish information achieved from websites about developmental dysplasia of the hip using standardized scientific methods.

Amaç: Anne sütü ve mama ile beslenmenin plazma toplam antioksidan kapasiteye etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Anne sütü ya da mama ile beslenen üç ile altı ay arası 34 süt çocuğunda plazma toplam antioksidan ve oksidan seviye ölçülerek oksidatif stres indeksi hesaplandı Çalışma için etik kurulundan onay 14 10 2009 10 7 alınmıştır. Bulgular: Anne sütü ile beslenen grup ile mama ile beslenen grup arasında cinsiyet ve yaş ile toplam antioksidan ve oksidan seviye değerleri arasında anlamlı bir ilişki bulunamadı Anne sütü alan grupta toplam antioksidan seviye değerleri mama alan gruba göre anlamlı yüksek bulundu p=0 004 Anne sütü alan grupta toplam oksidan seviye değerleri mama alan gruba gruba göre düşük bulundu p=0 019 Anne sütü alan grupta oksidatif stres indeksi değerleri mama alan gruba göre düşük bulundu p=0 006.Çıkarımlar: Altı aydan küçük yaş grubunda anne sütü ile beslenme mama ile beslenmeye göre daha iyi bir antioksidan savunma sağlar., Aim: We aimed to evaluate the effect of breast milk and formula on the total antioxidant capacity of the plasma Material and Method: The oxidative stress index was calculated by measuring plasma total antioxidant level and total oxidant level in 35 infants between the ages of 3 and 6 months The study approved by the ethics committe 14 10 2009 10 7 Results: No significant differences were observed between the two groups in respect of age gender plasma total antioxidant status and total oxidant status Plasma total antioxidant levels were higher in the breast fed group than the formula fed group p=0 004 Plasma total antioxidant status was lower in the breast fed group compared to the formula fed infants p=0 019 The oxidative stress index values of the breast fed group were lower than formula fed infants p=0 006 Conclusions: Breast milk provides better antioxidant defence than does formula in infants before six months of age Turk Arch Ped 2012; 47: 95 8

Akut poststreptokoksik glomerulonefrit cocuklardaki akut hipertansiyonun en sik nedenlerinden biridir. Reverzibl posteriyor ensefalopati sendromu PRES , siklikla bilinen hipertansiyon veya immunsupresif ilac kullanimi durumlarinda ortaya cikan bir klinik-radyolojik tablodur. PRES’in karakteristik semptomlari bas agrisi, kusma, gormede bozukluklar, bilinc degisiklikleri ve nobetlerdir. Norolojik sistem goruntulemelerinde en sik gorulen anormallik, beyin hemisferlerininin arka bolgelerinde, ozellikle pariyetooksipital bolgede, ak ve gri maddeyi tutan bilateral odemdir. Burada, akut bas agrisi, bilinc degisikligi, nobet ile basvuran ve APSGN’ye bagli PRES tanisi alan 11 yasinda bir erkek hastayi sunduk.

We aimed to evaluate the autonomic nervous system activity in children with overactive bladder (OAB) syndrome.Included in the study were 40 children with overactive bladder and 28 healthy controls. Autonomic tests were performed on all participants, including heart rate interval variation (RRIV), heart rate response to valsalva maneuver, and sympathetic skin response (SSR).Mean valsalva rates in the overactive bladder and control groups were 1.53 ± 0.29 and 1.30 ± 0.18, respectively, a statistically significant difference (P 0.001). Also significantly different were deep breathing RRIV values of the study and control groups: 56.65 ± 14.66 and 47.92 ± 10.15, respectively (P = 0.008). No statistical differences were found in SSR when OAB patients were compared with controls (P 0.05).This study demonstrated a parasympathetic hyperactivity in children with OAB, results suggesting a dysfunction in their autonomic nervous systems. Neurourol. Urodynam. 36:673-676, 2017. © 2016 Wiley Periodicals, Inc.