Effects of early physical therapy on motor development in children with Down syndrome.

Objective: The objective of the study was to compare the motor development of children with Down syndrome (DS) who received physical therapy (PT) and did not receive PT, and to show the effect of PT programs started before the age of one on movement development. Methods: The study included aged between 6 and 42 months, 58 children with DS. Children with DS were divided into two groups as receiving PT and non-receiving PT. Children with DS who received PT were further divided into two groups according to the age of starting PT as before and after 1 year of age. Gross motor and fine motor development of the cases were evaluated with Bayley Scales of Infant and Toddler Development III. Results: Gross motor scaled scores (GM-SS: 3.88±3.46-1.67±1.23), fine motor scaled scores (FM-SS: 4.29±3.24-1.79±0.93), and composite scores (64.4±19.5-50.38±5.38) of PT group were statistically higher than the non-PT group (p<0.05). In addition, GM-SS (5.22±4.23-2.38±1.20), FM-SS; (5.61±3.85-2.81±1.37), and composite scores (72.33±23.85-55.56±5.7) of the cases who started PT before the age of one were statistically higher than those who started after the age of one (p<0.05). Conclusion: Our results revealed that PT especially when started early childhood under had a positive effect on the development of gross and fine motor in children with DS and provided a scientific basis for referring children with DS to PT programs before the age of one. Clinicians should recommend PT for children with DS in the early period.

Sleep patterns of young children with newly diagnosed atopic dermatitis.

INTRODUCTION: Even though atopic dermatitis (AD) most often begins in the first year of life, it is not well known whether sleep disturbances occur following the onset of the disease or whether they develop later. AIM: To determine the sleep patterns of young children already diagnosed with AD in comparison to a control group by using a validated questionnaire, the Brief Infant Sleep Questionnaire (BISQ). MATERIAL AND METHODS: Forty-six children with a new diagnosis of AD and 60 healthy children, aged 3-36 months, participated in the study. Their sleep behaviors were assessed using the BISQ along with a structured sociodemographic data form. RESULTS: It was found that when compared with healthy children, children with AD did not have decreased daily total sleep duration (p = 0.1); however, it was found that they woke up more frequently at night (52.2% vs. 40%, p = 0.4) and they stayed awake significantly longer than 60 min when they woke up (41.3% vs. 11.7%, p < 0.05). In addition, mothers of children with AD reported that their children had three times as many sleep problems compared to the reports of mothers of healthy children. CONCLUSIONS: The findings of this study showed that sleep disturbance was more common in young children with already diagnosed AD, and the BISQ provided a practical way to assess the sleep patterns. The use of a screening tool to enable early identification and treatment of childhood sleep problems among patients with AD should be encouraged.

Human milk banking and milk kinship: Perspectives of mothers in a Muslim country.

AIM: The present study aims to determine the knowledge, attitudes and views of mothers regarding infant feeding, breast milk, wet-nursing, milk kinship and human milk banks. METHODS: This descriptive cross-sectional study was composed of 1042 mothers who delivered at two different hospitals in Turkey. RESULTS: Almost half of the participating mothers, 49.9%, agreed with the establishment of alternative HMBs in Turkey. Only 7.7% of the mothers in this study expressed views in favour of the establishment of Western-style HMBs. Approximately half of the mothers (42.4%) indicated that they were against the establishment of any kind of HMBs in Turkey. Only 9.2% of the mothers in this study stated that they would volunteer to donate their breast milk to the Western-style HMBs, and only 6.9% of the mothers approved obtaining milk from this type of HMB. Finally, 44.2% of the mothers stated that they would donate their breast milk to the alternative HMBs, and 31.9% of the mothers approved obtaining milk from this type of HMB. CONCLUSION: This is the first study conducted among mothers in a Muslim community about issues such as infant feeding, breast milk, wet-nursing, milk kinship and HMBs. The majority of the mothers in this study are against the establishment of Western-style HMBs, whereas they have a more positive response to an alternative HMB when their religious concerns are relieved.

Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement.

INTRODUCTION: This study aimed to evaluate renal involvement and factors affecting the prognosis in patients with Henoch-Schonlein purpura (HSP). MATERIALS AND METHODS: The outcomes of 107 children diagnosed with HSP who had been followed up for at least 6 months were reviewed. RESULTS: Renal involvement was observed in 26.1% of the patients. The mean age of the patients with renal involvement was 8.8 ± 4.0 years as compared to 7.1 ± 2.9 years in the patients without renal involvement (P = .02). The risk of renal involvement was found to be significantly higher in the patients who were 10 years old and over (P < .001). In the group with renal involvement, the frequency of scrotal involvement was significantly higher than that of the group without renal involvement (P = .02). The mean serum immunoglobulin A level of the patients with renal involvements was significantly higher (P = .04) and the mean serum complement C3 levels was significantly lower (P = .04) than those of the patients without renal involvement. None of the patients with renal involvement reached end-stage kidney failure. No significant relationship was observed between the development of renal involvement and early steroid treatment. CONCLUSIONS: This study proposes that in old children with HSP, elevated serum immunoglobulin A levels, decreased serum complement C3 levels, and scrotal involvement are associated with renal involvement. We failed to find any effect of steroid treatment on development of renal involvement.

Comparison of brain apparent diffusion coefficient value in naturally and assisted conceived newborns.

BACKGROUND: Our aim was to assess the value of brain apparent diffusion coefficient (ADC) in Intra Cytoplasmic Sperm Injection (ICSI) and spontaneously conceived preterm singletons. METHODS: Twenty ICSI-conceived preterm singletons and 20 gestational age matched spontaneously conceived preterm singletons were studied. All subjects underwent diffusion-weighted imaging (DWI). The main outcome measure was the brain ADC value in the in ICSI-conceived and naturally conceived newborns. RESULTS: Children born after ICSI had an increased ADC value than the controls. The ADC values of ICSI-conceived singletons were higher than those of spontaneously conceived singletons at cerebellum, corpus striatum, frontal lobe, occipital lobe, and temporal lobe white matter. The mean Apgar score, birth weight, height, and head circumference of ICSI children were found to be similar to naturally conceived children. CONCLUSIONS: Measuring ADC value may be a promising marker in identifying neurological outcome of ICSI-conceived newborns.

Is "premature sebaceous hyperplasia" really a sebaceous hamartoma? Report of a case with neonatal onset.

Sebaceous hyperplasia is a common benign proliferation of the sebaceous gland. It commonly presents in middle-aged people as soft, yellow papules with central umbilication on the face, particularly on the forehead. We report a newborn with striking unilateral sebaceous hyperplasia and suggest that this may represent a unique sebaceous hamartoma rather than "premature sebaceous hyperplasia."

Baby walkers: a perspective from Turkey.

AIM: To determine in an urban population in Turkey, the frequency of baby walker (BW) use, beliefs and attitudes of mothers regarding BWs, frequency of BW-related injuries and whether families receive counselling from their paediatricians about BWs or not. METHODS: Children aged 2 months to 5 years who attended the well-child care clinics of Fatih University Hospital in Ankara comprised the sample. A semi-structured questionnaire was verbally administered. RESULTS: Of 495 children, 75.4% was found to use BW. Female gender [odds ratio (OR) = 1.82, 95% confidence interval (CI) =1.19-2.78) and lower maternal education (OR = 0.37, 95% CI = 1.18-0.74) were found to be associated with BW use. Frequencies of injuries associated with BWs were low (7.8%). Only 92 (18.6%) families received appropriate counselling by their paediatricians. CONCLUSION: The results of our study show that BW use is common in urban Turkey. Families are not informed about the lack of benefits and potential hazards of BWs and base reasons of using and not using on unique cultural beliefs rather than informed, evidence-based decisions. Paediatricians in Turkey and potentially other countries require information about the need for counselling families about the hazards associated with BW use.

Promoting child development at sick-child visits: a controlled trial.

OBJECTIVE: In developing countries, the health care system often is the only existing infrastructure that can reach young children, and health care encounters may be the only opportunity for professionals to have a positive influence on child development. To address the discrepancy between Western and developing countries related to the information that is available for caregivers on how to support their child's development, the World Health Organization Department of Child and Adolescent Health and Development and United Nations International Children's Education Fund have developed the Care for Development Intervention. The Care for Development Intervention aims during acute health visits to enhance caregivers' play and communication with their children. For facilitation of its delivery worldwide, the Care for Development Intervention was developed as an additional module of the Integrated Management of Childhood Illness training course. The purpose of this study was to determine the efficacy and the safety of the Care for Development Intervention when implemented during a young child's visit for acute minor illness. METHODS: The study design is a sequentially conducted controlled trial, with the comparison arm completed first, Care for Development Intervention training provided for the clinicians next, followed by the intervention arm. At the Pediatric Department of Ankara University School of Medicine, 2 pediatricians who were blinded to the study aims and hypotheses before Care for Development Intervention training provided standard health care to the comparison group; they then received Care for Development Intervention training and provided standard health care plus the Care for Development Intervention to the intervention group. Compliance with treatment and the outcome of illness were determined by a follow-up examination in the clinic 1 week later. One month after the clinic visits, an adapted Home Observation for Measurement of the Environment was administered in the homes by researchers who were blinded to study aims and hypotheses. RESULTS: Children who were aged < or = 24 months and attended the clinic with minor or no illnesses were recruited for the study: 113 in the comparison group and 120 in the intervention group. At the 1-month home visit, significantly more families had optimal Home Observation for Measurement of the Environment scores (17.5% vs 6.2%), more homemade toys were observed (42.5% vs 10.6%), and more caregivers reported reading to their children (20.0% vs 3.5%) in the intervention than in the comparison group. Three independent predictors of optimal Home Observation for Measurement of the Environment score emerged from the logistic regression analysis: being in the intervention group, child ages >6 months, and maternal education greater than secondary school. Compliance with medical treatment and illness outcomes were not significantly different between the 2 groups. CONCLUSIONS: The Care for Development Intervention is an effective method of supporting caregivers' efforts to provide a more stimulating environment for their children and can be used by health care professionals during visits for acute minor illness.