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Objective: We investigated whether the results of leptin gene (LEP) 2548G/A (rs7799039) and leptin receptor gene (LEPR) 668 A/G (rs1137101) variants, as well as the methylation analysis of CpG regions at nucleotides −31 and −51 of the LEP gene, showed any differences between breastfed and non-breastfed children in this study. Materials and Methods: The cross-sectional study included 100 children aged 2–5 years who were attending nursery and kindergarten and had been accepted to the Department of General Paediatrics. Infants who were exclusively breastfed for the first six months after birth constituted the study group, and those who were not only breastfeed constituted the control group. Methylation percentages at CpG islands of the LEP gene were compared between exclusively breastfed and non-exclusively breastfed infants, and the statistical significance was analyzed by looking for changes in LEP −31 and −51 nt methylation and LEP 2548G/A ve LEPR 668 A/G variants. Results: Both groups were compared by feeding, and the association of LEPR and LEP gene polymorphisms and −51 nt and −31 nt methylations were analyzed. There were no significant differences between the groups regarding genotype and allele frequency for the LEPR 668 A/G, LEP 2548 G/A gene variant, −31 nt methylation, and −51 nt methylation status. Similarly, there was no significant difference in genotype and allele frequency for the LEPR 668 A/G gene variant in terms of duration of exclusive breastfeeding, total breastfeeding, body mass index, family obesity, and satiety status. However, maternal support from family elders and physical activity increased the 51 nt methylation, but this methylation was not significantly affected by BMI, age, or satiety status. Conclusions: Maternal support from family elders and physical activity were associated with increased 51 nt methylation, but this methylation was not significantly affected by BMI, age, or satiety status. However, there are not enough studies in this area to reach a definitive conclusion, and further research is needed.

As social media becomes increasingly ubiquitous, many events are recorded and released on social media platforms, including chemical weapon attacks. We develop an objective tool in order to evaluate brief and unstructured social media videos for analysing sarin exposure from a civilian medical pathology perspective. We developed and validated this new questionnaire using a standardized procedure that includes content domain specification, item pool generation, content validity evaluation, a pilot study, and assessment of reliability and validity. In total, 51 sarin attacks and 48 matched videos were analysed. Cronbach’s α for all 20 items was 0.75, which indicates adequate internal reliability. The test–retest reliability was 0.96, which indicates good internal reliability. The inter-observer intraclass correlation coefficient was 0.97. After verifying sampling adequacy with the Kaiser–Meyer–Olkin measure and the factorability of the items with Barlett’s test of sphericity, a factor analysis was performed. According to the principal axis factoring, a six-factor solution explained 51.86% of the total variance. The receiver-operating characteristic curve analysis showed that the Video Score Questionnaire has a sensitivity of 0.817, a specificity of 0.478, and an efficiency of 65.3. Therefore, the Video Score Questionnaire is reliable and valid for evaluating sarin attacks from brief and unstructured social media videos. Key points Chemical weapons are still used as a method of warfare. Social media videos are an important source of information. We developed a validated scale which can analyse sarin exposure in short and unstructured videos.

Background: Despite primary vaccination, infants under six months run a risk of infection with pertussis. Objective: To determine the impact of early postpartum maternal pertussis vaccination on protecting infants from the disease. Methods: All mothers (n=405) who gave birth to healthy term infants were educated on the cocoon strategy. The mothers who consented were immunized with the tetanus-diphtheria-acellular pertussis vaccine within the first three postpartum days. All infants received their pertussis vaccines according to the national schedule. The anti-pertussis IgG titers of infants of thirty vaccinated mothers were compared with those of thirty unvaccinated mothers. Results: The pertussis antibody levels in the infants of vaccinated mothers were significantly higher than those of unvaccinated mothers at the mean infant age of 5.6 ± 1.2 months. Only 6 infants of vaccinated mothers exhibited pertussis-like symptoms, none of whom had positive pertussis PCR. Seventeen infants of unvaccinated mothers had pertussis-like symptoms, and 4 tested positive for pertussis PCR. Conclusion: Our results showed that maternal pertussis vaccination, administered within the first three postpartum days, may protect infants against pertussis in their first ten months.

Background To investigate the behaviour of the inflammatory marker neutrophil-to-lymphocyte ratio (NLR) in the presence of peripheral blood eosinophilia (PBE) in paediatric asthma patients with lower respiratory tract (LRT) infections. Methods This retrospective study enrolled consecutive patients aged ≥5 years who were diagnosed with asthma and whose haemogram values were available. The patients were further subdivided based on the presence or absence of LRT infections and allergies. NLR and C-reactive protein (CRP) were evaluated in relation to the presence or absence of PBE (≥4% eosinophils). Results A total of 991 patients were enrolled in the study. Patients with LRT infections had significantly higher leucocyte and neutrophil counts, a greater NLR and a higher level of CRP compared with patients without LRT infections. Overall, patients with PBE had significantly lower NLRs and CRP regardless of the presence or absence of an LRT infection. The PBE percentage showed moderate inverse correlations with NLR ( r = −0.34) and CRP ( r = −0.20). Conclusion The presence of PBE was significantly associated with lower NLR and CRP regardless of the presence or absence of an infectious condition.

Infectious mononucleosis is an acute lymphoproliferative disorder caused by the Epstein-Barr virus (EBV) and seen most commonly in children and young adults. Clinical presentation of the disease is characterized by fever, tonsillopharyngitis, lymphadenopathy, and hepatosplenomegaly, whereas serological findings of this benign disorder include positive heterophilic antibody formation (transient increase in heterophilic antibodies) and prominence of hematological lymphocytosis of more than 10% of atypical lymphocytes. An EBV infection is usually asymptomatic in childhood, but acute kidney injury can be a rare complication during its course. Most cases recover from the disease completely. Early recognition of EBV infection and estimation of its complication are important for its prognosis. In light of previous literature, we discuss the case evaluated as an EBV infection complicated by acute kidney injury in early childhood and results of tubulointerstitial nephritis shown on a renal biopsy that was later diagnosed as an EBV infection by serological examination.

Aim: Vitamin D deficiency is highly prevalent among children worldwide. This study aims to assess the frequency of vitamin D deficiency in children and how it varies according to gender, age, and season in Istanbul. Materials and methods: The study included 3096 children aged 0-18 admitted to the pediatric outpatient clinic in Istanbul. The serum 25 hydroxyvitamin D concentration was categorized into four groups: deficiency (100 ng/mL). Descriptive methods, Chi-square, Independent Samples T-Test, ANOVA, and correlation test were used in the statistical analysis of the data. Results: Of children, 52% were girls and 48% boys. The mean serum 25 hydroxyvitamin D concentration was 21.8 ± 15.8 ng/mL, and the frequency of vitamin D deficiency was 53.1%. There was a different distribution of vitamin D status between age groups. Vitamin D deficiency was more common in older children. There was also a significant difference between girls and boys in the frequency of vitamin D deficiency (57.6% versus 48.3%). The mean serum 25 hydroxyvitamin D concentration was significantly lower in winter and spring. A moderate negative correlation was found between age and serum 25 hydroxyvitamin D concentration (correlation coefficient:-0.36). Conclusion: This study showed that female sex, older children, and the winter/spring seasons were significantly associated with a higher frequency of vitamin D deficiency and a lower mean serum 25 hydroxyvitamin D concentration.

Hypomelanosis of Ito (HI) is characterized by unilateral or bilateral hypopigmented skin lesions and usually presents as a multisystemic disorder. Skin lesions may develop in different textures, such as linear, whorled, or patchy, and are often accompanied by abnormalities of the central nervous system, skeletal system, eyes, and teeth. HI is associated with sporadic gene mutations but not gender. Presentation of the current case may be of use in reminding practitioners of the common extracutaneous findings of HI, along with some rare manifestations, such as delayed speech and asymmetric limb growth.

INTRODUCTION[|]The overload of pediatric emergency units around the world has become an increasing problem for patients and health care professionals alike. Researching the features of pediatric emergency services will provide the necessary information for creating an effective emergency medical system, increasing patient satisfaction, and reducing the treatment costs. In this study; we aimed to check the admissions in pediatric emergency rooms, evaluate the effectiveness of emergency service, and develop suitable strategies to increase the amount and quality of medical service given in pediatric emergency rooms.[¤]METHODS[|]In this retrospective study, the records of 296,858 (51.2% female, 48.8% male) patient admissions in the emergency rooms and 384,171 (46.3% female, 53.7% male) admissions in the outpatient clinics of eight hospitals between January 2015 and June 2015 were scanned. Out of these hospitals, two facilities were research and training hospitals.[¤]RESULTS[|]The average age of patients who were admitted to the emergency room was 89.1 (+-21.3) months and the average age of patients admitted to the outpatient clinics was 87.2 (+-18.7) months. Upper respiratory tract infection was the most frequent (44.23%) diagnosis in the emergency rooms and most of these infected patients (63.67%) had been admitted to the two training and research hospitals that provide an advanced level of health care. Also, the patient requests for diagnosis were determined to be significantly high in emergency rooms.[¤]DISCUSSION AND CONCLUSION[|]Proper understanding of the scope of emergency services is very important in order to provide fast and effective healthcare to the patients who get admitted to emergency rooms and maintain appropriate and judicious use of the resources of emergency rooms.[¤]

Objectives: To investigate the effect of rapid antigen testing (RAT) on the practice of antibiotic prescription as well as the accuracy of peripheral blood neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) values in detecting group A beta-hemolytic Streptococcus (GABHS) in children with tonsillopharyngitis.Methods: In a multicenter study performed in Turkey, we retrospectively analyzed data from 668 consecutive pediatric patients under 17 years of age, who presented with signs and symptoms of tonsillopharyngitis and underwent RAT. The rates of positive and negative RAT results were determined and patients' antibiotic prescriptions were examined in relation to RAT results. In addition, the accuracy of peripheral blood NLR and CRP values was examined for 212 patients whose laboratory data were available, with RAT as the reference standard.Results: Positive RAT results were observed in 190 of 668 (28.4%) patients. Antibiotics were prescribed to all 190 patients with positive RAT results and to 8 of 478 patients with negative RAT results. Overall, the rate of antibiotic prescription was 29.6%. Patients with positive and negative RAT results did not differ significantly with regard to NLR and CRP values. In ROC analysis, the area under the ROC curve (AUC) of NLR and CRP were 0.54 (95% confidence interval [CI] 0.45–0.64), and 0.55 (95% CI 0.45–0.65), respectively.Conclusion: RAT results proved highly associated with antibiotic prescribing, suggesting that RATs could be of great value in preventing unnecessary antibiotic use. Our findings also suggest that NLR and CRP are poorly accurate to identify GABHS in children with tonsillopharyngitis.

Taenia saginata is one of the species of intestinal tapeworms for which humans are the only definitive hosts. It occurs worldwide; however, it emerges mostly where the consumption of improperly cooked beef is common. Most human carriers are asymptomatic, and patients who are symptomatic may sense the movement of proglottids through the anus. Other associated symptoms are nausea, epigastric pain, and anorexia. The diagnosis is usually established by macroscopic determination and microbiological tests. Praziquantel and niclosamide are the therapeutic agents for the treatment. This study aimed to report a case of a 4-year-old boy, in which T. saginata proglottids were expelled through the nose and anus.

Background: Family history of premature atherosclerosis imposes a high risk to people. The relationship between atherosclerosis and gene polymorphisms of various biomarkers such as Endothelial Nitric Oxide Synthase (eNOS), C-Reactive Protein (CRP), and Interleukin-6 (IL-6) has shown in previous studies. Aims: The major aim of the study was to evaluate the CRP, eNOS, and IL-6 gene polymorphisms in a group of adolescents who have a parental history of early coronary artery disease (CAD). Study Design: Case-control study. Methods: Thirty-six volunteers with a father with obstructive CAD during the first four decades and 46 subjects with a father with normal coronary arteries documented with coronary angiography were included in the study. Polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze CRP, eNOS, and IL-6 polymorphisms. Results: We did not find any differences between the two groups with regard to age, sex, body mass index, renal functions, systolic and diastolic blood pressures, lipid profile, and fasting glucose, hemoglobin, and high sensitivity CRP. A significant difference was only observed in IL-6-572 G/C genotype distribution and allele frequency between two groups (Pc=0.036 OR=3.48 CI (95%) 1.17-10.32). Conclusion: The present study showed a significant association between the IL-6-572 G/C gene polymorphism (presence of C allele) and adolescents with a parental history of premature CAD.