A Case of Child Physical Abuse With a Rolling Pin Insertion, Resulting in Bladder and Rectal Perforation.

Visceral injuries are not uncommon in nonaccidental trauma and often require emergent operative intervention. However, sometimes it can be difficult to assess the extent of injury. In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to our hospital as acute abdomen with intraperitoneal free fluid on ultrasonography. An exploratory laparotomy revealed the perforations and surgical repair was performed. The patient was evaluated by the Hospital Child Protective team and it was revealed that bladder and rectum perforations were due to insertion of rolling pin into the rectum by the stepmother. The child was discharged home uneventfully with a temporary colostomy. We believe that this is the first reported case in the English literature of inflicted perforation of the rectum and bladder through insertion of a rolling pin.

The relationship between aggression, empathy skills and serum oxytocin levels in male children and adolescents with attention deficit and hyperactivity disorder.

Although attention deficit and hyperactivity disorder (ADHD) are recognized as neurodevelopmental disorders characterized by impairment in executive functions, impairments in social functioning are often accompanied by ADHD. Oxytocin (OT) has been investigated in a number of psychiatric disorders owing to its effects on social interactions. The aim of this study was to determine the relationship between aggression, empathy and OT levels in children with ADHD. Forty male patients with ADHD, ranging in age from 7 to 18 years, and 40 healthy age-matched and sex-matched individuals were included in this study. The patients and healthy controls filled in the Buss-Perry Aggression Questionnaire and Bryant's Empathy Index for Children and Adolescents; the Reading the Mind in the Eyes test was then completed. Blood samples were collected for OT at the beginning of the study. Lower serum OT levels were observed in patients with ADHD compared with the healthy controls. Moreover, there was a negative correlation between serum OT level and aggression scores and a positive correlation between the serum OT level and empathy scores in patients with ADHD. We conclude that OT may play a role in aggression and empathy skills, affecting the social life of those with ADHD.

A life-threatening presentation of child physical abuse: jejunal perforation.

Intra-abdominal injuries from impacts are the second most common cause of death in battered children. However, it may be difficult to distinguish between accidental abdominal injury and abuse, especially in the absence of other clinical findings. Published reports are also limited about the diagnosis of abuse in children with intra-abdominal injury. We report a case with jejunal perforation, multiple soft tissue injuries, and occipital fracture secondary to child abuse who was initially admitted to our hospital with complaint of fever, cough, and vomiting. An exploratory laparotomy revealed perforation of the jejunum, and an end-to-end anastomosis was performed. The patient was evaluated by the hospital's child protective team to implement appropriate diagnostic and child-protective interventions, and the child was discharged home in 10 days.

Plasma phthalate and bisphenol a levels and oxidant-antioxidant status in autistic children.

Phthalates and bisphenol A (BPA) are endocrine disruting chemicals (EDCs) that are suggested to exert neurotoxic effects. This study aimed to determine plasma phthalates and BPA levels along with oxidant/antioxidant status in autistic children [n=51; including 12 children were diagnosed with "Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)]. Plasma levels of BPA, di (2-ethylhexyl)-phthalate (DEHP) and its main metabolite mono (2-ethylhexyl)-phthalate (MEHP); thiobarbituric acid reactive substance (TBARS) and carbonyl groups; erythrocyte glutathione peroxidase (GPx1), thioredoxin reductase (TrxR), catalase (CAT), superoxide dismutase (SOD) and glutathione reductase (GR) activities and glutathione (GSH) and selenium levels were measured. Plasma BPA levels of children with PDD-NOS were significantly higher than both classic autistic children and controls (n=50). Carbonyl, selenium concentrations and GPx1, SOD and GR activities were higher (p<0.05); CAT activity was markedly lower in study group. BPA exposure might be associated with PDD-NOS. Intracellular imbalance between oxidant and antioxidant status might facilitate its neurotoxicity.

A nationwide study of social-emotional problems in young children in Turkey.

We aimed to assess the prevalence of social-emotional problems of Turkish children in early childhood and to understand their association with various bio-psycho-social risk factors, in order to establish guidelines in planning training programs for parents and professionals. Data from a representative sample of 1507 boys (54.3%) and 1268 girls (45.7%) aged 10-48 months were collected. The primary caregivers (mothers=91.4%) completed the Brief Infant-Toddler Social and Emotional Assessment (BITSEA), the Brief Symptom Inventory (BSI) and a form designed to gather information about various bio-psycho-social risk factors. Based on the caregiver terms, a total of 1626 children (60.1%) were reported to experience social-emotional problems. However, based on the BITSEA-problem clinical (1.5 SD) cut-off scores, 9.3% (9.1% of boys; 9.5% of girls) of all children were found to experience social-emotional problems. The variables, that showed a significant association with BITSEA-problem scores in pairwise comparisons, were entered in logistic regression analysis to determine the variables that predict the group with scores of above clinical cut-point. Higher total score of BSI of the primary caregiver, being separated from the mother for more than a month, and lower income of the family were found to be significant predictors of social-emotional problems. Caregiver reports highlight that maternal variables of mothers' psychological well-being, education and access to sources of support are closely related to the social-emotional wellbeing of their off-spring. The findings obtained from this study may be used for detection of prioritized domains in terms of management of preventive mental health services.