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The purpose of this study was to evaluate the relationship between the presence of pneumonia and blood parameters in cases of Coronavirus disease (COVID-19) and to examine their predictive characteristics in terms of pneumonia. We reviewed the file records of 151 pediatric patients with a diagnosis of COVID-19 confirmed by the real time-reverse transcription polymerase chain reaction test in nasopharyngeal swabs. The patients were divided into two groups based on direct chest X-ray and computed tomography results in [Group 1 (n:41), with pneumonia findings, and Group 2 (n:110), with no pneumonia findings]. The groups’ demographic data, clinical and laboratory findings were compared. Pulmonary involvement was determined in 41 (27.1%) of the 151 patients. The [body mass index (BMI) Z-score], red blood cell distribution width (RDW), mean platelet volume (MPV), neutrophil lymphocyte ratio, passive leg raise, and D-dimer levels were significantly higher in patients with pneumonia than those without pneumonia in our study. Based on multivariate logistic regression analysis, BMI Z-score, MPV, and RDW were found to be independent risk factors of pneumonia in patients. The current study showed higher levels of blood parameters in patients with coronavirus disease 2019 (COVID -19) presenting with pneumonia than those without pneumonia. We suggest that BMI-Z score and MPV value may assist in predicting pulmonary involvement in patients with COVID-19.

Objective: Long recreational screen time affects many aspects of children's health. We aimed to assess the association of screen time with isometric back and leg muscle strength in school-aged children. Method: Healthy children aged between 7-11 years were enrolled in this study. Gender of the children, their weight, and height at enrollment were recorded. A research assistant surveyed the parents of each child with face-to-face interview technique in order to analyse child's screen-viewing behavior. Children participating in the study were divided into 2 groups according to their average daily screen time (group 1: ≤ 2 hours, group 2: >2 hours). The children in Groups 1 and 2 were also divided into subgroups according to their body mass index (BMI) percentiles. The back and leg muscle strength were measured by using isometric back-leg strength dynamometer. The demographic characteristics, BMI Z-scores and the back and leg muscle strength of the children in groups were compared statistically. Results: A total of 307 children including 103 boys (33.6%) and 204 girls (66.4%) were enrolled in the study. There were 204 (66.4%) and 103 (33.6%) children in groups 1 and 2, respectively. There was no statistically significant difference between the two groups in terms of back and leg muscle strength. The BMI Z-score of children positively correlated with their back and leg muscle strength, respectively. Conclusion: This study could not find an association between screen time and both back and leg muscle strength of children. There is a need for further studies to analyse the effects of other confounding factors such as physical activity, sedentary behaviors, sleep duration and quality, sociodemographic factors and seasonal influence in associaton with screen time in muscle strength outcome measures in children.

Aim: We aimed to reveal the similarities and differences between the rare and severe multisystem inflammatory syndrome (MIS-C) and active familial Mediterranean fever (FMF) disease in children. Our study may help in the early recognition of MIS-C syndrome in children and distinguish it from other diseases with similar symptoms. Methods: We evaluated the demographic and clinical characteristics, laboratory findings, treatments and outcomes of patients with MIS-C syndrome and active FMF. Results: The clinical and laboratory findings of a total of 66 patients hospitalized in our pediatric clinic with the diagnosis of active FMF (n: 42) and MIS-C syndrome (n: 24) were reviewed retrospectively. The reason for pediatric emergency admission was determined as resistant fever in all patients. When the clinical findings of the patients were compared, it was determined that joint and abdominal pain in the FMF group and vomiting, rash, cough, Lenfadenopati (LAP) and myalgia findings in the MIS-C group were statistically significantly higher (p

Bismuth intoxication is a rare cause of acute kidney injury (AKI) and is usually reversible by appropriate therapeutic measures. We present here a case of an adolescent pregnant girl who developed AKI due to an overdose of colloidal bismuth subcitrate (CBS, total amount of 6 g). She received parenteral chelating agent dimercaprol for 14 days. Continuous venovenous hemodiafiltration (CVVHD) with high-flux membrane was carried out in the first 3 days of chelating therapy and intermittent hemodialysis for 11 days, thereafter. The patient recovered clinically and was discharged after 21 days. She gave birth to a healthy term boy. At the last visit, the baby was 6 months old with normal growth and development as well as normal kidney functions. Neither deterioration in renal functions nor emergence of proteinuria was recorded in the patient during follow-up care after hospital discharge. In cases of AKI due to an overdose of CBS, treatment with dimercaprol combined with high flux hemodiafiltration and subsequently hemodialysis appears to be both useful and safe for bismuth elimination. [ABSTRACT FROM AUTHOR]

Background Urinary tract infections (UTI) are one of the most common bacterial infections in children and a major cause of hospitalization. In this study we investigated the clinical characteristics, causative uropathogens; their antibiotic susceptibility and resistance patterns, treatment modalities and efficacy in children hospitalized for UTI in a tertiary care setting. Methods Patients hospitalized for an upper UTI between March 2009 and July 2014 were enrolled. The urine culture-antibiogram results and accompanying urinary tract abnormalities were recorded retrospectively. Results A total of 142 patients (104 girls, 73.2%; 38 boys, 26.8%) were enrolled. Mean patient age was 32.6 ± 4.1 months. History of recurrent UTI was present in 45.8% (n = 65), with prior hospitalization in 12.0% (n = 17). Frequency of vesicoureteral reflux was 18.3% (n = 26). Gram-negative enteric microorganisms yielded growth in all culture-positive UTI and the most common microorganism was Escherichia coli (n = 114, 80.3%). Extended spectrum beta-lactamase-producing (ESBL (+)) bacterial strains were detected in 49.3% (n = 70), with third-generation cephalosporin resistance in all and increased duration of hospitalization. Conclusions The prevalence of UTI with ESBL (+) bacterial strains with multi-drug resistance is increasing in the hospitalized pediatric population, therefore rational use of antibiotics is essential. [ABSTRACT FROM AUTHOR]

Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory disorder caused by mutations in the TNFRSF1A gene encoding the 55-kDa receptor for tumor necrosis factor (TNF)-α. It is characterized by recurrent prolonged episodes of fever accompanied by abdominal pain, pleuritis, migratory skin rashes, fasciitis, headache, conjunctivitis, and periorbital edema. We report two children, one with a severe mutation in the TNFRSF1A gene causing the typical phenotype. The second patient had a homozygous R92Q-type mutation and displayed a periodic fever with aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome-like phenotype. In the eastern Mediterranean region, TRAPS is probably underdiagnosed because of the overwhelming frequency of familial Mediterranean fever (FMF). However, TRAPS should be sought for in patients with atypical symptoms for FMF. [ABSTRACT FROM AUTHOR]

Takayasu arteritis (TA) is a large vessel vasculitis that involves the aorta, its major branches and pulmonary arteries. Diagnosis of TA during childhood remains challenging due to the non-specific symptoms. We report a four-year-old girl presenting with fever, fatigue, weight loss, and elbow pain who was later diagnosed as childhood TA. On admission, she had fever, hypertension, decreased pulses, bruits, hepatosplenomegaly, and increased erythrocyte sedimentation rate and C-reactive protein level. Computed tomography angiography showed luminal narrowing and wall thickening in ascending aorta, brachiocephalic, left common carotid and left vertebral arteries and descending aorta. Oral corticosteroid (prednisone, 2 mg/kg/day) was instituted, later followed by oral methotrexate (12.5 mg/m²/week). TA is rare in children; however, childhood TA must be considered in children who present with non-specific systemic symptoms, hypertension and increased acute phase reactants. [ABSTRACT FROM AUTHOR]

A 53/12-year-old boy with Philadelphia chromosome (+) pre-B acute lymphoblastic leukemia (ALL) without extramedullary involvement did not achieve remission after induction therapy. His family stopped therapy, but he was readmitted eight months later due to pyoderma, pneumonia and active leukemia with leukocytosis. During cytoreductive and antibiotic therapy, he developed progressive abdominal distension, pain, globe vesicale, tachypnea, and respiratory alkalosis. Bowel sounds could not be auscultated. Dilation, mainly in the large intestine, was detected radiologically. His neurological examination revealed absence of superficial reflexes and hypoesthesia along with normal motor strength and deep tendon reflexes in the lower extremities, consistent with conus medullaris syndrome, which was thought to give rise to acute colonic pseudo-obstruction. [ABSTRACT FROM AUTHOR]

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