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Objective The aim of this study was to determine the clinical characteristics, course of disease, and outcomes of patients admitted to our pediatric intensive care unit (PICU) for Crimean–Congo hemorrhagic fever (CCHF). Methods Data of all patients with CCHF who were admitted to PICU during a 3-year period and whose diagnosis was confirmed by serological methods or polymerase chain reaction were retrospectively reviewed. Their presenting characteristics, treatments, and outcomes were extracted from the hospital's electronic database. Disease severity scoring was performed using the severity scoring index and severity grading score system. Results The data of 22 of 123 patients with suspected CCHF who were admitted to PICU were evaluated. Among them, 68.2% were males and mean age of all patients was 13.4 ± 2.2 years. The average length of stay of 10 patients was >10 days. On average, 3.72 units of platelet suspension per patient was transfused. In the course of the disease, the highest laboratory values were reached on day 3 of admission. Conclusion Poor CCHF outcome depends on thrombocytopenia severity, prolonged coagulation tests, high-liver enzyme levels, and disseminated intravascular coagulation. Poor outcomes can be avoided by CCHF awareness and preparedness, early diagnosis of the disease, and supportive treatment with appropriate fluid and blood product transfusion. Randomized controlled trials on prophylactic transfusion and ribavirin use are needed.

Objective: Familial Mediterranean Fever (FMF) is an autoinflammatory disease characterized by recurrent fever, arthritis, and inflammation of the serous membranes, with an autosomal recessive with recurrent attacks and is a disease that begins in childhood and lasts a lifetime. In this study, it was aimed to evaluate the relationship between disease activity and dental fear-anxiety, and dental behaviour level in children with FMF who had pain and hospital experience in early childhood. Materials and Methods: The study included 207 children ranging in age from 5 to 15 years; 93 patients with FMF and 114 healthy controls. Dental anxiety and dental fear were measured using the Frankl Scale and Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS). Age, sex, disease severity activity, and duration of illness were examined. Results: There was no statistical difference in dental anxiety and fear between the FMF and healthy group (p>.05). However, there was a statistically significant difference in the effect of disease severity activity on the CFSS-DS. The anxiety and fear in FMF patients was similar to healthy children, which was low. Conclusions: Dental anxiety and fear level in FMF patients was similar to healthy children, which was low. It is necessary to avoid the idea that all chronic diseases will cause dental anxiety and fear, and they should be evaluated according to the nature of the chronic disease.

Objectives The aim of this study was to evaluate the stiffness of the neonatal brain using 2-dimensional shear wave elastography in term and preterm neonates and to investigate possible stiffness differences between groups. Methods A total of 83 neonates, including 44 term and 39 preterm, were included in the study. Shear wave elastographic measurements of the thalamus and occipital periventricular white matter were conducted via the anterior fontanel. The Pearson correlation coefficient was used to determine the association between the birth week and stiffness values of the thalamus and periventricular white matter. A receiver operating characteristic analysis was applied to determine the power of the stiffness of the thalamus and periventricular white matter in predicting a significant preterm classification. P

Background: Neonatal thrombocytopenia is a common hematological abnormality that occurs in 20–35% of all newborns in the neonatal intensive care unit. Platelet transfusion is the only known treatment; however, it is the critical point to identify neonates who are really at risk of bleeding and benefit from platelet transfusion as it also has various potential harmful effects. Aims: To investigate the prevalence and risk factors of neonatal thrombocytopenia and its relationship to intraventricular hemorrhage in the neonatal intensive care unit and to determine whether the use of platelet mass index-based criteria could reduce the rate of platelet transfusion. Study Design: Retrospective cohort study. Methods: This study was conducted in the neonatal intensive care unit of a tertiary university hospital. The medical records of neonates in the neonatal intensive care unit with platelet counts

Amaç: Çocuklarda hastanede yatışlara ve gereksiz antibiyotik kullanımına neden olmasından dolayı viral gastroenteritlerin erken tanımlanması önemlidir. Rotavirüs ve adenovirüs çocuklarda en sık rastlanan viral gastroenterit etkenleridir. Bu çalışmanın amacı akut gastroenteritli çocuk hastalardan alınan gaita örneklerinde rotavirüs ve adenovirüs sıklığının araştırılmasıdır.Gereç ve Yöntem: Bu çalışmada ………Üniversitesi Tıp Fakültesi Araştırma veUygulama Hastanesi Mikrobiyoloji Laboratuvarı’na Ocak 2017- Ocak 2018 tarihleriarasında gastroenterit tanısı alan çocuklardan, rotavirüs ve adenovirüs antijenleriaraştırılmak üzere gönderilmiş olan gaita örneklerinin test sonuçlarıretrospektif olarak değerlendirildi. Rotavirüs ve adenovirüs 40/41 antijenleriimmünokromatografi yöntemi ile araştırıldı. Bulgular: Çalışmada rotavirüs antijenleri araştırılmak üzere gönderilmiş olan 1635hastanın gaita örneği ile adenovirüs antijenleri araştırılmak üzere gönderilmişolan 1608 hastanın gaita örneği analiz sonuçları değerlendirildi.133 hastada (% 8.1) rotavirüs, 30 hastada (% 1.8) adenovirüs ve yedi hastada (%0.4) rotavirüs ve adenovirüs birlikte pozitif olarak tespit edildi. Rotavirüsantijeni pozitifliği 13-24 aylık grupta diğer yaş gruplarına göre istatistikselolarak anlamlı düzeyde yüksek (p0.05). Rotavirüs gastroenterit vakalarının büyük kısmının(% 43.6) kış mevsiminde olduğu ve bunun isatistiksel olarak anlamlı olduğutespit edildi (p

WOS: 000485766800006, PubMed: 31555571, Purpose: The beta 3-adrenergic receptor (ADRB3) is expressed in visceral adipose tissue and has been speculated to contribute to lipolysis, energy metabolism, and regulation of the metabolic rate. In this study, we aimed to investigate the association of polymorphism of the ADRB3 gene with the sex of children with obesity and related pathologies. Methods: ADRB3 gene trp64arg genotyping was conducted in 441 children aged 6-18 years. Among these subjects, 264 were obese (103 boys; 161 girls) and 179 were of normal weight (81 boys; 98 girls). In the obese group, fasting lipids, glucose and insulin levels, and blood pressure were measured. Metabolic syndrome (MS) was defined according to the modified World Health Organization criteria adapted for children. Results: The frequency of trp64arg genotype was similar in obese and normal weight children. In obese children, serum lipid, glucose, and insulin levels; homeostasis model assessment of insulin resistance (HOMA-IR) scores; and MS were not different between arg allele carriers (trp64arg) and noncarriers (trp64trp). In 264 obese children, genetic analysis results revealed that the arg allele carriers were significantly higher in girls than in boys (p=0.001). In the normal weight group, no statistically significant difference was found between genotypes of boys and girls (p=0.771). Conclusion: Trp64arg polymorphism of the ADRB3 gene was not associated with obesity and MS in Turkish children and adolescents. Although no relationships were observed between the genotypes and lipids, glucose/insulin levels, or HOMA-IR, the presence of trp64arg variant was frequent in obese girls, which can lead to weight gain as well as difficulty in losing weight in women.

Giriş: Zehirlenmeler çocukluk çağı acil hastalıklar arasında morbidite ve mortalitenin önlenebilir nedenleri arasında yer alır. Bu çalışmada Tokat ili ve çevresinde görülen çocukluk çağı zehirlenmelerinin epidemiyolojik özelliklerini belirlemeyi amaçladık. Yöntemler: Gaziosmanpaşa Üniversitesi Tıp Fakültesi çocuk yoğun bakım ünitesine 01/02/2014 ile 30/06/2016 tarihleri arasında yatan 148 zehirlenme olgusu geriye dönük olarak değerlendirildi. Bulgular: Çocuk Yoğun Bakım Ünitesinde yatırılarak izlenen olguların %50.3’ü kız, %49.7’i erkek idi. Zehirlenmelerin en sık görüldüğü yaş grubu 2-5 yaş olup (%40,1), bu dönemde en sık görülen zehirlenme etkeni ise farmakolojik ajanlardı. Zehirlenme etkenlerinin %74.8’i farmakolojik ajanlardı. Zehirlenme olgularının 45’i (%30,6) intihar amaçlı, 88’i (% 59.9) kaza sonucu meydana gelmişti. Mevsime göre dağılımda hastaların %25.2’i sonbahar, %22.4’i yaz ,%17.7’si kış, %34.7’si ilkbaharda başvurmuştu. Çalışmanın yapıldığı dönemde uygun takip ve destek tedavisi ile olguların hiçbirinde ölüm gözlenmedi. Sonuç: Bölgemizin zehirlenme profilinin belirlenmesinin, koruyucu önlemlerin alınmasına katkısı olabileceğini ve eğitim i,le zehirlenme oranlarının düşürülebileceğini düşünmekteyiz. &nbsp

Ozet Amac: Henoch-Schonlein purpurasi (HSP) cocukluk ca­ginda en sik gorulen vaskulit olup; basta deri, eklem, bobrek ve GIS olmak uzere bircok organi etkileyebilen sistemik bir hastaliktir. Bu calismanin amaci 2010-2015 yillari arasinda klinigimizde HSP tanisi ile izlenen hastalarin klinik ve laboratuvar ozelliklerinin degerlendirilmesidir. Gerec ve Yontem: Bu calismada Tokat Gaziosmanpasa Universitesi Tip Fakultesi Cocuk Sagligi ve Hastaliklari Klinigi’nde 2010-2015 yillari arasinda HSP tanisi alarak tedavi ve takibi yapilan 53 hastanin dosyalari geriye donuk olarak incelendi. Hastalarin tanisi; 1990 Amerikan Romatoloji Birligi HSP tani olcutlerine gore en az iki olcutun var olmasina dayanilarak konuldu. Tedavide nonsteroid antienflamatuvar ve/veya kortikosteroid kullanildi. Bulgular: Hastalarin 28’i kiz, 25’i erkekti. Hastalarin yas araligi 3-17 yil, yas ortalamasi 9,8 yil idi. Klinik bulgulardan cilt dokuntusu hastalarin tamaminda mevcuttu. Artrit/artralji 24 (%45.3), karin agrisi 33 (%62.3), bas agrisi 6 (%11.3) hastada goruldu. Proteinuri 22 (%41), hematuri 9 (%17) ve gaitada gizli kan pozitifligi 20 (%37.7) hastada tespit edildi. 25 hastada (%47) bobrek tutulumu, 33 hastada (%62.3) GIS tutulumu mevcuttu. GIS tutulumu olan 20 hastaya (%37.7) steroid tedavisi verildi. 6 hasta (%11) agir bobrek bulgulari olmasi nedeniyle ileri inceleme yapilmak uzere Cocuk Nefroloji Klinigi olan dis merkeze sevk edildi. 15 (%28.3) hastada dokuntulerin tamamen gectikten sonra ilk 6 ay icinde tekrar ortaya ciktigi goruldu. Sonuc: HSP cilt ve eklemler basta olmak uzere bircok organ ve sistemi tutabilen bir vaskulit olup, kisa donemde prognozunun iyi oldugu ve hastalarin cogunlugunun sekelsiz iyilesebildigi gorulmustur. Bununla beraber erken ve gec donemde gelisebilecek ozellikle GIS ve bobrek tutulumu gibi komplikasyonlar acisindan yakin takip edilmelidir.

The present study examined the relationship between clinical findings and mutation analyses in children with Familial Mediterranean Fever (FMF) in the inner Black Sea region of Turkey. This retrospective, cross-sectional study included patients with FMF who were evaluated between 2007 and 2015. FMF was diagnosed according to the Tel Hashomer criteria. FMF mutations were analyzed using a Real-time PCR System (Roche Diagnostics, Mannheim, Germany), and patients were classified into three groups according to allele status. The most common symptom was abdominal pain (99%, n = 197). The most frequent mutations were M694V and R202Q. Chest pain was reported more often in patients homozygous for M694V (61.4%). Although fever, abdominal pain, and arthritis were more commonly observed with the M694V mutation, chest pain was the most common symptom in R202Q carriers (n = 10, 32.3%). Proteinuria was observed in 42 (21.2%) patients, frequently accompanied by the M694V mutation (28.6%). The most common mutations in children with FMF in Turkey were M694V and R202Q. Recurrent abdominal pain and arthritis/arthralgia were commonly observed in patients with M694V and R202Q mutations. Moreover, chest pain was commonly seen with the R202Q mutation. Thus, R202Q might be a disease-causing mutation in FMF patients.

Obesity, one of the most common disorders observed in clinical practice, has been associated with energy metabolism-related protein genes such as uncoupling proteins (UCPs). Herein, we evaluated UCPs as candidate genes for obesity and its morbidities.A total of 268 obese and 185 nonobese children and adolescents were enrolled in this study. To determine dyslipidemia, hypertension, and insulin resistance, laboratory tests were derived from fasting blood samples. UCP1-3826 A/G, UCP2 exon 8 deletion/insertion (del/ins), and UCP3-55C/T variants were also genotyped, and the relationships among the polymorphisms of these UCPs and obesity morbidities were investigated.The mean ages of the obese and control groups were 11.61 ± 2.83 and 10.74 ± 3.36 years, respectively. The respective genotypic frequencies of the AA, AG, and GG genotypes of UCP1 were 46.3%, 33.2%, and 20.5% in obese subjects and 46.5%, 42.2%, and 11.4% in the controls (p = 0.020). G alleles were more frequent in obese subjects with hypertriglyceridemia (42.9%; p = 0.048) than in those without, and the GG genotype presented an odds ratio for obesity of 2.02 (1.17-3.47; p = 0.010). The polymorphisms of UCP2 exon 8 del/ins and UCP3-55C/T did not influence obesity risk (p 0.05). The I (ins) allele was associated with low HDL cholesterolemia (p = 0.023).The GG genotype of the UCP1-3826 A/G polymorphism appears to contribute to the onset of childhood obesity in Turkish children. The GG genotype of UCP1, together with the del/del genotype of the UCP2 polymorphism, may increase the risk of obesity with synergistic effects. The ins allele of the UCP2 exon 8 del/ins polymorphism may contribute to low HDL cholesterolemia.

WOS:000401302900012 PubMed: 28421785 Background and aim: Childhood obesity is associated with an increased risk of chronic disease. We aimed to determine the association between vitamin D deficiency and cardiovascular risks in obese children. Method: The studied children were selected from obese children who were followed up at obesity clinic, aged 6-17 years. Basic demographic information and laboratory data were collected retrospectively from hospital records. Results: A total of 310 students (178 [57.4%] girls) were evaluated for 25-hydroxyvitamin D (25[ON] D) levels in late winter/spring. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 62.3%, 34.5%, and 3.2%, respectively. Insulin resistance was observed in 146 (47.1%) children; the frequencies of dyslipidemia and hypertension were 31% and 19.4%, respectively. The mean atherogenic dyslipidemia ratio was higher in the deficient group (p = 0.049). Inverse correlations of 25(OH) D levels were observed with homeostasis model assessment of insulin resistance values (r = -0.146, p = 0.010). The mean values of 25(011) D (ng/mL) were lower in girls (12.15 +/- 6.60) than in boys (16.48 +/- 8.69) (p < 0.05) and in children with hypertension (11.92 +/- 5.48) than in those without (14.50 +/- 8.24) (p < 0.05). Conclusions: Vitamin D deficiency is observed more frequently than expected in obese children and adolescents. Our findings indicate that low 25(OH) D levels are associated with insulin resistance. Vitamin D deficiency could contribute to the morbidities associated with childhood obesity, such as insulin resistance or diabetes mellitus, increased cardiovascular/cardiometabolic risks, atherogenic dyslipidemia, and hypertension.

Adrenal hemorrhage occurs most frequently in the newborn, but it has been also well documented in older children and adults. There are several reasons in etiology and clinical symptoms can vary widely depending on the residual adrenal function. In this case; despite bilateral massive adrenal hemorrhage, no etiologic factor had been found and adrenal insufficiency was not present. To our knowledge, our patient is a spontaneous idiopathic bilateral massive adrenal hemorrhage case without adrenal insufficiency which is the first one reported in a pediatric patient in literature., Adrenal kanama çoğunlukla yenidoğan döneminde görülse de daha büyük çocuklarda ve erişkinlerde de olabilmektedir. Etiyolojide birçok neden rol oynamakta ve klinik bulgu ve belirtiler çeşitlilik gösterebilmektedir. Sunulan vakada masif adrenal kanamaya rağmen adrena yetersizlik gözlenmemiş ve herhangi bir etiyolojik faktör bulunamamıştır. Bilgilerimize göre literatürdeki çocukluk çağında spontan idyopatik bilateral masif adrenal kanaması olan ancak adrenal yetersizlik gelişmeyen ilk vaka olma özelliğini taşımaktadır.

WOS:000393323800004 PubMed: 28123331 Aim: Hypercalciuria is an important cause of urinary tract symptoms, and also frequently results in urolithiasis. Urinary calcium excretion varies for geographic areas. We aimed to assess percentiles of urinary calcium excretion and prevalence of hypercalciuria for school-aged children in Tokat (city located in inner northern region of Turkey). Material and Methods: One thousand three hundred seventy-five children aged 6 to 18 years were enrolled in the study. Urine samples were obtained randomly. The children's variables as sex, age, length, and weight were recorded. Urinary calcium and creatinine determined from the urine samples and urinary calcium/creatinine ratios (mg/mg) were calculated. Percentiles of urinary calcium/creatinine ratios were also assessed for each age of the children. Results: Six hundred eighty-three of the 1 375 children were girls and 692 were boys. The mean age of the children was 11.68 +/- 3.43 years. Some 23.9% of the children were living in rural regions and 76.1% were were living in urban regions. The mean urinary calcium/creatinine ratio was 0.080 +/- 0.24 and the 95th percentile value of the urinary calcium/creatinine ratio was 0.278. The hypercalciuria prevalence for school-aged children was 4.7% when the urinary calcium/creatinine ratio value for hypercalciuria was accepted as >= 0.21. The prevalence of hypercalciuria in rural and urban regions was 7.60% and 3.82%, respectively (p0.05). Conclusion: The prevalence of hypercalciuria and urinary calcium excretion vary for different geographic areas, not only for countries. The percentiles of urinary calcium excretion should be assesed for every geographic region and the prevalance of hypercalciuria should be determined with these values. There is controversy as to whether obesity is a risk factor for hypercalciuria.

PubMedID: 27173647 [No abstract available]

Giriş: Alt solunum yolu enfeksiyonları (ASYE); tüm dünyada çocukluk çağında hastaneye yatış gerektiren ve mortaliteye sebep olan nedenlerin başındagelmektedir. Bu çalışmanın amacı; viral ASYE tanısıyla yenidoğan yoğun bakım ünitesinde (YYBÜ) izlenen hastaların özelliklerinin değerlendirilmesi, viraletkenlerin ortaya konulması ve risk faktörlerinin araştırılmasıdır.Gereç ve Yöntem: Bu çalışmada; bir üniversite hastanesinde 3. basamak YYBÜ’ye Ocak 2018 ve Mart 2020 tarihleri arasında takip ve tedavi için yatırılıp viral ASYEtanısı koyulan hastaların özellikleri ve solunum yolu viral paneli sonuçları geriye dönük olarak incelendi. Hastalar RSV (+) saptananlar ve RSV-dışı viral etkensaptanalar olmak üzere iki gruba ayrıldı ve gruplar karşılaştırıldı.Bulgular: Çalışmaya 24 hasta dahil edildi. SYVP sonuçlarında 6 (%25) hastada RSV-A, 8 (%33,3) hastada RSV-B, 10 (%41,6) hastada RSV dışı viral etkenlersaptandı. RSV saptanan hastalar ile RSV dışı etkenlerin saptandığı hastalar arasında sosyo demografik özellikler açısından fark bulunmazken; RSV saptanangrupta akciğer grafisinde infiltrasyon varlığı (pnömoni) daha fazla, solunum ya da oksijen desteği alma oranı daha yüksek ve ortalama yatış süresi daha uzun olaraksaptandı (p değerleri sırasıyla 0,001, 0,001 ve 0,017). Yatış süresi ile C-reaktif protein düzeyi arasında pozitif yönde, orta düzeyde korelasyon saptandı (r=0,558,p=0,005).Sonuç: YYBÜ’de viral ASYE’de en sık etken RSV olarak bulunmuştur. Bu nedenle YYBÜ’de çalışanların hijyen kurallarına çok dikkat etmeleri veziyaretçilerin de bu konuda ciddi şekilde eğitildikten sonra YYBÜ ortamına alınmaları vurgulanmalıdır. Viral ASYE düşünülen hastalarda erken tanı-tedaviyapılabilmesi ve hastalığın yayılımının önlenebilmesi için viral testlere ulaşımın artırılması ve testlerin yaygınlaştırılması önem arz etmektedir.