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Background: The World Health Organization (WHO) recommends the use of tachypnea as a proxy to the diagnosis of pneumonia. Objective: The purpose of this study was to examine the relationship between body temperature alterations and respiratory rate (RR) difference (RRD) in children with acute respiratory infections(ARI). Methods:This cross-sectional study included 297 children with age 2-60 months who presented with cough and fever at the pediatric emergency and outpatient clinics in the Department of Pediatrics, Baskent University Hospital, from January 2016 through June 2018. Each parent completed a structured questionnaire to collect background data. Weight and height were taken. Body temperature, respiratory rate, presence of the chest indrawing, rales, wheezing and laryngeal stridor were also recorded. RRD was defined as the differences in RR at admission and after 3 days of treatment. Results: Both respiratory rate and RRD were moderately correlated with body temperature (r=0.71, p

Giriş Erken neonatal sepsis ve solunum sıkıntısı sendromu, erken doğan bebeklerde yaşamın ilk günlerinde neonatal mortaliteye yol açmaktadır. Bu çalışmanın amacı, premature bebeklerde spot idrar albümin / kreatinin oranının erken neonatal sepsis ve solunum sıkıntısı sendromunun erken tanı göstergesi olup olmadığını belirlemektir. Yöntem 34. haftadan erken doğan 126 prematüre bebek prospektif olarak incelenmiştir.Bu çalışmada yaşamın birinci, üçüncü ve yedinci gününde serum albümin, kreatinin, C-reaktif protein (CRP) ve spot idrar albümin / kreatinin oranlarını değerlendirdik. Ayrıca bu parametrelerin, erken doğan bebeklerde yaşamın ilk günlerinde erken neonatal sepsis ve solunum sıkıntısı sendromu ile ilişkisini araştırdık. Bulgular Yaşamın ilk ve yedinci gününde spot idrar albümin / kreatinin oranı ile erken neonatal sepsis grubu arasında istatistiksel olarak anlamlı fark vardı (p = 0.01). Solunum sıkıntısı sendromu grubunda idrar albümin / kreatinin oranları istatistiksel olarak anlamlı değildi. Serum albümin konsantrasyonları ve spot idrar albümin / kreatinin oranı yaşamın ilk günlerinde korelasyon göstermemiştir. Ayrıca yaşamın ilk günlerinde gebelik yaşı, doğum ağırlığı ile spot idrar albümin / kreatinin oranı arasında ilişki yoktu. Sonuçlar Bulgularımız, Çalışmamız doğum sonrası erken dönemde spot idrar albümin / kreatinin oranının prematüre bebeklerde erken neonatal sepsisi tanımlayabildiğini göstermektedir.

Objective: The present study aimed to evaluate the biochemical markers of bone turnover in children with congenital hypothyroidism during the course of treatment as compared to healthy children selected as controls. Methods: The study included 31 children with congenital hypothyroidism and 29 healthy children. In both groups, we evaluated serum procollagen type-1 N-terminal propeptide (PINP) and tartrate-resistant acid phosphatase type 5b isoform (TRACP 5b) levels as bone turnover markers. Results: In both groups, thyroid hormone levels were within normal limits. The levels of vitamin D were significantly higher in the cases with congenital hypothyroidism. Although PINP levels were not found to be different, TRACP 5b levels which are related to osteoclastic activities were significantly higher in the control group. Conclusion: We did not detect an increase in bone resorption in patients with congenital hypothyroidism, despite long-term treatment with LT4. Our results suggest that with effective vitamin D treatment and thyroxin replacement, congenital hypothyroidism is not a deleterious factor for bone turnover.

Sekiz yaşından küçük kız çocuklarında cinsel olgunlaşma belirtisi olmadan meme gelişimi, neredeyse evrensel olarak prematür telarş (PT) olarak kabul edilir. Prevelans ve etiyoloji açıkça bilinmemektedir. Çalışmamızda, unilateral veya bilateral PT olan kız çocuklarını izlemini yapmak ve bakım ürünlerini kullanmayı bıraktıklarındaki gerilemeyi göstermeyi amaçladık.Çalışma retrospektif planlandı. Eylül 2016 ile Şubat 2017 tarihleri arasında izlemde olan prematür telarş tanısı almış çocuklar ve ebeveynleri çalışmaya dahil edildi. Sağlam çocuk izleminde olan pubik veya aksiller kıllanma, vajinal kanama veya diğer cinsel olgunlaşma bulgusu ile ilişkisi olmayan unilateral veya bilateral meme gelişimi olan tüm çocukların tek semptomu vardı. Organik bir neden saptanmayan bu çocuklarda, bakım ürünleri kesildikten sonra izleme alındı. 28 kız çocuğu değerlendirildi ve ortalama yaş 2,3 (± 0,3) yıl idi. Çocukların kronik hastalığı yoktu. Tüm vakalar Tanner evre 2 olarak tanımlandı ve erken meme gelişimi nedeniyle takibe alındı. 18 (%64,2) kız çocuğun unilateral meme gelişimi vardı. Bakım ürünleri kullanmayı kestikten sonra, unilateral ve bilateral meme gelişimi olan çocuklarda 6 ay içinde gerileme oldu. Günümüzde, PT ve Puberte prekoks veya erken meme gelişimi riskini gösteren herhangi bir öngörücü test yoktur. Çocukların, bakım ürün kullanımı nedeniyle birçok teste maruz kalabilir. Klinisyenler bu türlü ürünler yönünden dikkatli olmalıdırlar. Aileler çocukları için bakım ürünlerinin kullanım miktarını asgari düzeyde tutabilirler., Backround: Breast development, without any signs of sexual maturation, in girls younger than 8 years is almost universally accepted as premature thelarche (PT). Prevalance and etiology are clearly unknown.Objectives: We designed a study to follow up girls who had unilateral or bilateral PT and to show regression after stopping care products. Material and Methods: The design of study was retrospective Children and their parents were enrolled into the study from September 2016 to February 2017. All children had one common symptom which was unilateral or bilateral breast development not associated with pubic or axillary hair, vaginal bleeding or other sign of sexual maturation, at the well child visit. In these children with no organic causes, monitoring was taken after stopping of care products. Result: 28 girls were evaluated and mean age was 2,3 years (± 0,3). Noone had a chronic disease. All cases identified as Tanner stage-2 and continued to have early breast development on follow-up. 18 (64,2%) girls had unilateral breast development. After stopping care products, both group had regression in six months. Conclusions: Currently there are no predictive tests to show the risk of breat development of early or puberty precoccus. Children may be exposed to much more diagnostic tests because of overuse products. Physician must be aware of these products. Families may use a minimum amount of care products for their children.

Tum acil servis basvurularin %30’ unu olusturan Cocuk Acil Servis basvurulari gerekli onlemlerin alinmasina ragmen hala yuksek oranini korumaya devam etmektedir. Sunulan hizmetin daha iyi ve bilimsel olmasi acisindan acile servis verilerinin degerlendirilmesi oldukca onem tasimaktadir. Calismamizda ebeveynlerin cocuk acil servislerine basvurmasina neden olan sikâyetlerinin tespit edilmesi ve degerlendirilmesi amaclanmistir. Degerlendirmede 01.01.2014 – 31.12.2017 tarihleri arasinda, Cocuk Acil Servisine basvurular esas alindi. Triyaj yapan saglik personeli tarafindan ebeveynin ilk ve onemli buldugu sikayeti, hastanin yasi, yatis, recete ve sevk bilgileri kayit altina alindi. 24 saat icerisinde tekrarlayan basvurular degerlendirmeye disi birakildi. Basvuran 132654 hastanin %52,8’ i erkek ve %47,2’ si kizdi. Yas dagilimlarina bakildiginda, yenidogan doneminde %2,1, 1 ay ile 2 yas arasinda %34,5, 2 yas ile 6 yas arasi %31,2, 6 yas ile 11 yas arasi % 19,9, 11 yas ile 18 yas arasi ise %12,3 oldugu goruldu. En sik basvuru sebebi; enfeksiyona ait nedenler (%44,24) agri (%17,8) ve gastrointestinal nedenler (%14,5) olarak bulundu. Basvuran hastalarin yarisina recete ile ayaktan tedavi verilirken, %1,5’i servis ve yogun bakim yatislarinin uygun goruldugu belirlendi. Calismamizda ebeveynlerin cocuklarini acil servise getiris kaygilarinin, ates ve oksuruk gibi enfeksiyon kaynakli nedenler oldugu tespit edildi. Sonuclar degerlendirildiginde, alaninda deneyimli saglik calisanlarinin ates ve oksuruk ile seyreden hastaliklar hakkinda bilgi vermelerinin ebeveynlerin gereksiz kaygilarini azaltabilecegini ve bu sekilde acil servis basvurularini da azaltabilecegi dusunuldu.

OBJECTIVE The aim of this study was to analyze maternal and neonatal interleukin 6 (IL-6) (-174 G/C) polymorphism and to determine effect on preterm birth and neonatal morbidity. STUDY DESIGN One hundred and sixty-four mothers (100 term births, 64 preterm births) and 183 newborn infants who were 100 healthy term and 83 preterm babies followed in newborn intensive care units were evaluated. PCR-RFLP was performed for IL-6 (-174 G/C) genotyping. RESULTS The rate of GG genotype in mothers of term and preterm infants were 54% (n = 54/100), 75% (n = 48/64), respectively (p > .05) and the rate of GC + CC genotype was 46% (n = 46/100) and 25% (n = 16/64) in mothers giving term and preterm birth (PTB), respectively (p

To evaluate the agreement between integrated management of childhood illness (IMCI) and final diagnosis in patients presenting with cough at the second and third level health institutions. This cross-sectional study included 373 children aged 2–60 mo who presented with cough at the pediatric emergency and outpatient clinics in the Department of Pediatrics. After clinical examination of children, body temperature, respiratory rate, saturation, presence or absence of the chest indrawing, rales, wheezing and laryngeal stridor were recorded. Cases were categorized according to IMCI algorithm regarding the severity using the color code, such as red (urgent treatment), yellow (treatment in the hospital), or green (treatment at home). Final diagnosis after physical examination, laboratory analysis and chest X-ray was compared with the IMCI algorithm. Study agreement between IMCI classification and final diagnosis was 74.3% with kappa value 0.55 (moderate agreement). Similar agreement values were detected in both the second and third level health institutions. Health condition and gender did not affect agreement value. Agreement were found to be high in patients

Acute urticaria is an immune-inflammatory disease, characterised by acute immune activation. There has been increasing evidence showing that vitamin D deficiency is associated with increased incidence and severity of immune-inflammatory disorders.The aim of this study was to evaluate serum vitamin D levels in acute urticaria.We enrolled 30 children with acute urticaria and 30 control subjects. Concentrations of 25-hydroxyvitamin D [25(OH)D], a biomarker of vitamin D status, were measured in serum of acute urticaria patients and compared with the control group.There were no significant differences in baseline variables (age, gender, weight) between the groups. Vitamin D deficiency (20ng/ml) was significantly higher in patients with acute urticaria than in control patients. Serum 25(OH)D levels were significantly lower in the study group compared to those in the control group (13.1±4.3 vs 28.2±7.4ng/mL, p0.05). Moreover, we found negative correlation between mean duration of acute urticaria and serum vitamin D levels (p0.01).This study revealed a significant association of lower serum 25(OH)D concentrations with acute urticaria and an inverse relationship with disease duration. These findings may open up the possibility of the clinical use of vitamin D as a contributing factor in the pathogenesis of acute urticaria and a predictive marker for disease activity in acute urticaria. A potential role of vitamin D in pathogenesis and additive therapy in acute urticaria needs to be examined.

To evaluate serum vitamin D levels in cases of recurrent respiratory infections and chronic cough and to investigate the effect of vitamin D therapy on recurrence of the diseases. This prospective observational study was performed by comparing serum vitamin D levels in children with recurrent respiratory infections, chronic cough and healthy children. One-hundred-one children with chronic cough, ninety-eight children with recurrent respiratory infections and one-hundred-twenty-four healthy children were enrolled in the study. A structured questionnaire was completed to collect data on demography, diet, duration of breastfeeding, vitamin D supplementation and family history for allergic diseases. In patients with low serum vitamin D levels (

Gastroenteritis-related seizures have increasingly gained attention in recent years. Most cases follow a brief, benign course with very few episodes of seizure recurrence and without development of epilepsy. Published reports usually do not make a distinction between febrile and afebrile patients, and most authors include only nonfebrile convulsions in their reported series. This study evaluated the impact of fever in children presenting with seizures during a mild gastroenteritis episode and found that the presence or absence of fever did not affect seizure characteristics or duration. However, mild hyponatremia affected some seizure features, particularly seizure duration, as hyponatremic children sustained more prolonged seizures than patients with normal serum sodium levels, irrespective of body temperature.

Background and Aims To determine the demography, clinical manifestations and the most common organism isolated of the urinary tract infection (UTI) in the newborn infants who were admitted to the neonatal intensive care unite (NICU). Methods Newborn infants diagnosed with UTI were investigated retrospectively, clinical and demographic characteristics of infants were collected from the medical records in the NICU. Urine cultures were obtained by suprapubic aspiration or urinary cathater. Results Fifty-one infants were included in this study. The mean (±SD) gestational age and weight of infants were 31.53±4.32 weeks, and 1724.90±902.21 g respectively. Male patients accounted for %56.9 of the study group. Infants born with cesarian section were %86.3. The median age for the urine culture was 31.53±4.3days. Klebsiella pneumania was the dominant microorganism isolated in 22 patients (43.13%), followed by Escherichia coli in 13 patients (25.4%). The most common presenting symptoms were vomitting in 39(76.5%) infants, desaturation in 34 (66.7%) infants, tachycardia in 31 (60.8%) infants, apnea in 21 (41.2%) infants and jaundice in 18 (35.3%) infants. Conclusions The incidence of UTI in newborn infants is 0.1–1% and it can be as high as 10% in low-birthweight and preterm babies. The presentation of UTI in the neonatal infants is non-specific and the most common clinical manifestations are vomitting, fever, enteral feeding intolerance, apnea and bradycardia. In this study, desaturation and tachycardia are also shown as presenting manifestations of UTI. Klebsiella pneumania was the dominant microorganism isolated in 22(43.13%) patients in our study.