Early Childhood Education During the COVID-19 Outbreak: The Perceived Changing Roles of Preschool Administrators, Teachers, and Parents.

Stakeholders (teachers, preschool administrators, and parents) in early childhood education have struggled due to the COVID-19 outbreak. The present study explores the experiences and perceptions reflecting the perceived changes in the roles of stakeholders in early childhood education as a result of the COVID-19 pandemic in Turkey. A criterion sample of two administrators, nine teachers, and seven parents in early childhood education institutions was interviewed. We used Moustakas's (Phenomenological research methods, Sage, Thousand Oaks, 1994) phenomenological method to collect, analyze, and validate the data. The main themes showed that: (1) Stakeholders have experienced substantial challenges in online education; (2) The online delivery of instructional content has changed the administrators' financing and instructional leadership role; (3) Teachers have acquired new roles in some areas such as communication, content development, and technology use. In addition, the mentoring roles and social responsibilities of administrators and teachers have increased due to the COVID-19 pandemic; and (4) Supporting roles towards their children have been proliferated and diversified. Overall, findings from the present study provided insights into the stakeholders' perceived accumulated and altered roles in early childhood education because of the COVID-19 outbreak.

Treatment of Simultaneous Thromboembolism of the Right and Left Coronary Arteries with Thrombus Aspiration in a Patient with a Prosthetic Mitral Valve.

Prosthetic heart valve thrombosis is a rare, difficult-to-treat condition that increases morbidity and mortality by leading to systemic embolism. Clinically, it presents mainly in the form of stroke, though an embolism be observed in many systems. Acute coronary syndrome, which is rarely observed in patients with a prosthetic heart valve, mostly occurs as non-ST segment elevation myocardial infarction (MI). There is no specific recommendation for the treatment of this condition. Revascularization success rates have been shown to be variable in cases wherein thrombolytic therapy, balloon angioplasty, stent implantation, and a combination of all of these techniques are used. Herein are presented details of the successful revascularization of a patient with ST segment elevation MI presenting with simultaneous right and left coronary system embolism, and without embolism in any other system. In cases of acute coronary syndrome in patients with a prosthetic heart valve with no known coronary artery disease, starting the procedure with thrombus aspiration may prevent unnecessary stent and balloon angioplasty procedures being required, by accelerating the revascularization process.

Persistent smoking rate after coronary revascularization and factors related to smoking cessation in Turkey.

Background: Although smoking is an established risk factor for coronary artery disease, smoking cessation efforts, as part of a lifestyle change, have been disappointing so far. Therefore, assessing current smoking trends and identifying patients who are at risk of smoking continuation is of paramount importance. In this study, our aim was to assess current smoking rates after coronary revascularization as of 2017, and to define factors that potentially affect smoking cessation. Methods: Overall, 350 patients who had undergone coronary revascularization, either by percutaneous coronary intervention or bypass surgery were included in this cross-sectional, observational study. Patients were queried for various sociodemographic characteristics and smoking habits. Disease related data were obtained from the hospital archives. Results: The overall smoking rate was 57% after coronary revascularization. Age, bypass surgery and the occurrence of in-hospital adverse events were found to be independent predictors of smoking cessation in multivariate analysis. Conclusions: Despite efforts, smoking rates after coronary intervention remain substantially high. Therefore, a multidisciplinary approach to smoking cessation that incorporates cardiac rehabilitation programs and medications should be implemented in clinical practice.

Usefulness of Serum Omentin-1 Levels for the Prediction of Adverse Cardiac Events in Patients with Hypertrophic Cardiomyopathy.

OBJECTIVE: To investigate the association between serum omentin-1 levels and adverse cardiac events in patients with hypertrophic cardiomyopathy (HCM). SUBJECTS AND METHODS: This prospective, observational study included 87 patients with HCM and 50 age- and sex-matched control subjects. Serum omentin-1 and brain natriuretic peptide (BNP) levels were measured in all subjects, using enzyme-linked immunosorbent assay and electrochemiluminescence, respectively. Patients with HCM were divided into 2 groups according to their omentin levels, i.e., low: ≤291 ng/mL (n = 48) and high: > 291 ng/mL (n = 39). Cardiac mortality, hospitalization due to heart failure, and implantable cardioverter-defibrillator (ICD) implantation were considered adverse cardiac events. Statistical analysis included uni- and multivariant logistic regression, receiver-operating characteristic (ROC) analysis, and the Kaplan-Meier method. RESULTS: Serum omentin-1 levels were significantly lower in the obstructive (253.9 ± 41.3 ng/mL) and nonobstructive (301.9 ± 39.8 ng/mL) HCM groups than in the control group (767.1 ± 56.4 ng/mL), p < 0.001, respectively. The BNP levels were higher in the obstructive and nonobstructive HCM groups than in the control group (269.5 ± 220, 241.0 ± 227, and 24.0 ± 18.9 pg/mL, respectively, p < 0.001). The Kaplan-Meier analysis indicated that patients with low omentin-1 levels showed a significantly higher (48.2%) 2-year cumulative incidence of overall adverse cardiac events than those with high omentin-1 levels (16.2%) (log-rank test, p = 0.001). In the multivariate logistic regression analysis, omentin-1, interventricular septum (IVS) thickness, and male gender were independent predictors of adverse cardiac events in the follow-up. CONCLUSION: Omentin-1 levels were lower in patients with HCM than in the control group, and this was associated with worse cardiac outcomes.

Evaluation of Subtle Left Ventricular Systolic Dysfunction by Longitudinal Systolic Strain in Patients with Human Immunodeficiency Virus.

BACKGROUND: Although left ventricular systolic dysfunction (LVSD) is a major cause of morbidity in human immunodeficiency virus (HIV)-infected patients, there is limited data on cardiac functions of these patients. Compared to the conventional echocardiography, the global longitudinal strain (GLS) can detect subclinical myocardial dysfunction at an earlier stage. OBJECTIVES: In our study, we aimed to evaluate left ventricular systolic functions using the GLS in HIV-infected patients and to investigate the effect of cluster of differentiation 4 T-cell values on LVSD. METHODS: This prospective, case-control study included a total of 65 HIV-infected patients and 48 healthy volunteers. Conventional and strain echocardiography were performed on all participants. In HIV-infected patients, CD4 T-cell counts and HIV-ribonucleic acid (HIV-RNA) values were measured. RESULTS: The median CD4 T-cell count was 529.65 cells/mm3 in the HIV-infected patients and median duration of living with HIV was 16.25 (range: 2 to 120) months. Baseline characteristics and left ventricular ejection fraction values were similar in both groups. However, there was a significant difference in the low-density lipoprotein cholesterol, triglycerides, interventricular septum, left ventricular posterior wall, and GLS between the groups (p = 0.013, p = 0.005, 0.041, p = 0.013, and p = 0.003, respectively). There was a positive correlation between GLS and CD4 levels (r = 0.463, p < 0.001). CONCLUSIONS: Our study results suggest that reduced CD4 T-cell counts in HIV-infected patients may cause myocardial dysfunction and GLS can be useful to show subtle LVSD asymptomatic cases.

The Value of CHA2DS2VASC Score in Predicting All-Cause Mortality in Patients with ST-Segment Elevation Myocardial Infarction Who Have Undergone Primary Percutaneous Coronary Intervention.

BACKGROUND: Acute coronary syndrome is the most common cause of cardiac morbidity and death. Various scoring systems have been developed in order to identify patients who are at risk for adverse outcome and may benefit from more aggressive and effective therapies. OBJECTIVES: This study was designed to evaluate the CHA2DS2VASC score as a predictor of mortality inpatients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (p-PCI). METHODS: We evaluated 300 patients diagnosed with ST-elevation myocardial infarction who underwent p-PCI and calculated their CHA2DS2VASC scores. According to their CHA2DS2VASC scores, patients were divided into three groups. Group 1: 0-1 points (n = 101), Group 2: 2-3 points (n = 129), and Group 3: 4-9 points (n = 70). The mean, median and minimum duration of follow-up were 21.7 ± 9.4, 21, and 12 months, respectively. All-cause mortality was defined as the primary endpoint of the study. RESULTS: All-cause mortality was 4% in Group 1, 8.5% in Group 2 and 27.1% in Group 3 respectively. Kaplan-Meier analysis showed that Group 3 (CHA2DS2VASC ≥ 4) had a significantly higher incidence of death [p (log-rank) < 0.001]. In ROC analysis, AUC values for in hospital, 12-month and long-term mortality were 0.88 (0.77-0.99 95% CI), 0.82 (0.73-0.92 95% CI) and 0.79 (0.69-0.88 95% CI), respectively. CONCLUSIONS: CHA2DS2VASC score can be used for predicting both in-hospital, 12-month and long-term mortality in patients with STEMI who have undergone p-PCI.

Assessment of 25-Hydroxyvitamin D Levels in Patients with Resistant Hypertension.

OBJECTIVE: To investigate the possible correlation between serum 25-hydroxyvitamin D levels and resistant hypertension (RH). SUBJECTS AND METHODS: Patients who had undergone ambulatory blood pressure measurements (ABPM) during outpatient controls were enrolled. Fifty subjects with RH, 50 with controlled hypertension (CHT) and 50 normotensive subjects (NT) were included in the study. RH was defined as 'suboptimal blood pressure control despite using 3 antihypertensive agents including a diuretic or need for 4 or more drugs to control blood pressure'. The 25-hydroxyvitamin D and parathormone levels were compared between the groups. Pearson's correlation coefficient test was applied to assess the correlation between 25-hydroxyvitamin D levels and office blood pressure (BP) and ABPM. Logistic regression analysis was used to determine the independent correlates of RH. RESULTS: The 25-hydroxyvitamin D level was significantly lower in the RH group (17.02 ± 5.4 ng/ml) compared to the CHT (24.9 ± 4.8 ng/ml) and NT groups (28.0 ± 5.7 ng/ml, p < 0.001). In univariate correlation analysis, 25-hydroxyvitamin D levels had a significant negative correlation with office systolic BP (r = -0.329, p < 0.001), office diastolic BP (r = -0.395, p < 0.001), systolic ambulatory BP (r = -0.844, p = 0.004), and diastolic ambulatory BP (r = -0.567, p = 0.005). ROC analysis revealed that 25-hydroxyvitamin D levels <21.50 ng/ml predicted the presence of RH with a sensitivity of 78% and a specificity of 79% (AUC = 0.89, 95% CI 0.83-0.94). In the multivariate logistic regression analysis, 25-hydroxyvitamin D level was independently correlated with the presence of RH (ß 0.660, 95% CI 0.572-0.760, p < 0.001). CONCLUSION: There was an independent correlation between lower 25-hydroxyvitamin D levels and presence of RH.

Resistant spontaneous coronary artery spasm.

Coronary artery spasm should always be suspected in patients who have myocardial infarction with normal coronary arteries. This case report presents a 33-year-old woman with anterior myocardial infarction, whose coronary angiograph revealed normal left anterior descending artery and new onset complete occlusion of the circumflex artery at the time of the procedure. Nitroglycerin up to 800 mcg was administered without success. In such resistant cases, when all efforts fail, including prompt recognition and application of vasodilator drugs, retracting the catheter and waiting may play a role.

Evaluation of Cognitive Functions in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Prospective Pilot Study.

PURPOSE: It is not clear whether cognitive functions are impaired in young patients with acute coronary syndrome (ACS). This study aims to detect whether or not there is cognitive impairment and cerebral changes in young patients with ACS undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS: All 50 patients with ACS who were treated with primary PCI were eligible for this prospective study. All participants had normal cognitive function before ACS. Brain magnetic resonance imaging (MRI) was performed to quantify changes in brain white and gray matter. Cognitive functions (CFs) were evaluated by seven cognitive tests. Patients were categorized by MRI findings and test scores were compared from the first day to after the first month. RESULTS: We determined 25 patients with impaired CFs on the first day. After the first month, we identified 18 patients with transient impaired CFs. No structural difference was observed between impaired CF and normal CF. While 25 patients had a score of 1 according to Fazekas, 10 patients had a score of 1 according to MTLA. While the mean Stroop test completion time and Stroop test error rate scores were significantly higher on the first day than after the first month in the Fazekas+ group (p = 0.003, p < 0.001, respectively), other cognitive test scores-except clock drawing test, digital span forwards, and backwards-were significantly lower on the first day compared to after the first month in the Fazekas+ group (p < 0.05). CONCLUSIONS: Patients with ACS have transient impairment in cognitive functions. Acute coronary syndrome is not associated with structural changes in the brain.

Evaluation of Heavy Metal (Lead, Mercury, Cadmium, and Manganese) Levels in Blood, Plasma, and Urine of Adolescents With Aggressive Behavior.

Background Heavy metals can cause health problems by affecting the biological structure even at very low concentrations. Asymptomatic heavy metal poisoning causes non-specific symptoms such as behavioral disorders, difficulty in learning, and aggressive behaviors. There is also a great concern about the incidence of aggressive behavior among adolescents. A few research studies have concluded that a complex interaction or combination of factors leads to an increased risk of aggressive behavior in adolescents. This study aims to determine the correlation between the heavy metal levels in blood, plasma, and urine and the aggression level in adolescents. Materials and methods Two hundred twenty-eight adolescents between the ages of 13 and 19 were enrolled in the study. Blood, plasma, and urine heavy metal levels of the participants were measured by an inductively coupled plasma mass spectrometer (ICP-MS) device (Model 7700x; Agilent, Santa Clara, CA, USA). Buss and Perry's aggression questionnaire was used to investigate the correlation between heavy metals and aggressive behaviors in adolescents. Results Lead blood (r=0.34, p<.01), lead plasma (r=0.22, p<0.01), lead urine (r=0.31, p<.01), mercury blood (r=0.35, p<0.01), mercury urine (r=0.21, p<0.01), manganese blood (r=0.34, p<0.01), manganese plasma (r=0.33, p<0.01) and manganese urine (r=0.39, p<0.01) were positively correlated with tendency to aggression whereas no significant relationship was found between cadmium in blood, plasma, urine and mercury in plasma with aggression. Conclusion The study showed valuable data to associate a significant relationship between adolescents' aggression levels and heavy metals. There is an undeniable relationship between the health of adolescents and environmental pollution caused by heavy metals. Therefore, taking the necessary measures to prevent environmental heavy metal pollution is crucial for adolescent health.

Instruments for measuring service quality in sport and physical activity services.

Studies that conceptualize and measure quality in sport services date back to the last two decades. The present study aims to examine quality in sport services in terms of the classification of participant services and spectator services and to provide a summary of the empirical studies carried out to date. This study demonstrates that sport services literature is still in its infancy and no agreement exists on the developed models. Furthermore, the research models examined indicate that sports services not only possess different attributes and dimensions than other service industries but also differ in themselves. Consequently, the produced models need to be tested in the future on different sample groups for further clarification.

The training and employment of teachers of physical education and sports in Turkey.

This paper examines the phenomenon of training teachers of Physical Education and Sports (PES) in Turkey with respect to its dimensions of student quotas, graduates, and employment; and performs analytical evaluations through the numeric data. In the last five years, the number of labor force participants in PES teaching posts was 14,459 on average and the average employment volume was 10.29%, which means that a great number of graduates have accumulated against employment. Thus, this indicates that no realistic planning was done in the past years "so as to create a supply-demand equilibrium between training and employment of PES teachers".

Comparison of Vitamin D Levels and Related Factors in Pregnant Women and Neonates Exposed to Second-Hand Smoke.

INTRODUCTION: Exposure to second-hand smoke, a significant public health issue today, may lead to various health problems, especially in pregnant women and their infants. Low vitamin D levels during pregnancy may lead to preeclampsia and gestational diabetes in the mother, while it may cause low birth weight and respiratory problems in the infant. METHOD: The study group consisted of 42 mothers, who smoked regularly, and their infants and 45 mothers (passive smokers), who were regularly exposed to second-hand smoke in their home environment, although they did not smoke, and their infants. Meanwhile, the control group consisted of 46 healthy mothers, who did not smoke and were not exposed to second-hand smoke at home, and their infants with similar gestational age and birth weight. Blood samples were taken as two different samples, from the mother and the baby, and 25-hydroxyvitamin D (25(OH)D) and related blood parameters were studied and compared statistically. RESULTS: 25(OH)D, calcium, and magnesium levels of mothers who smoked were significantly lower than those who were exposed to second-hand smoke and those who did not. Moreover, the vitamin D levels of mothers and babies exposed to second-hand smoke in the non-smoker group were significantly lower than mothers and babies who were not exposed to second-hand smoke. In the babies of these three groups, a significant decrease was observed only in vitamin D levels. CONCLUSION:  The present study shows that pregnant women and their infants exposed to second-hand smoke have lower vitamin D levels. Hence, more emphasis should be put on vitamin D monitoring and supplementation to prevent severe health problems in pregnant women and their infants exposed to tobacco smoke. Further studies are needed to assess the associated risks for maternal and fetal health as well as possible long-term implications for the infant.

Vitamin D Deficiency and Its Clinical Results in Preeclamptic Mothers and Their Babies.

INTRODUCTION: Vitamin D deficiency during pregnancy may lead to many health problems by negatively affecting the metabolism of the newborn and the mother, such as infantile rickets, poor fetal and neonatal growth and development, gestational diabetes, and preeclampsia. We aimed to investigate the levels and clinical results of vitamin D in preeclamptic mothers and their babies. METHODS: The study group consisted of 42 preeclamptic mothers, and their babies diagnosed with preeclampsia according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria, while the control group consisted of 49 healthy mothers and babies with similar gestational age and birth weight. All pregnant women participating in the study were routinely taking 1200 IU of vitamin D3 daily supplements. The cord blood vitamin D level of both groups of newborns was measured and the results were statistically compared. RESULTS: The birth week, weight, and height averages and APGAR score averages measured at the first minutes of the babies in the study group (preeclamptic mother babies) were statistically significantly lower than those of the babies in the control group (babies of healthy mothers) (p=0.001, p=0.001, p<0.001, p=0.004, respectively). Vitamin D and calcium levels of the mothers in the study group were lower than those of the mothers in the control group. When the infants were examined, only the level of vitamin D was statistically significantly lower in infants in the patient group (p<0.001, p<0.001, p=0.001, respectively). CONCLUSION: There is consistent evidence of an association between low vitamin D concentrations and adverse preeclampsia outcomes. Since vitamin D deficiency is more common in preeclamptic mothers and their infants, higher-dose vitamin D supplementation than routine may be recommended to the patients.

Retrospective Evaluation of Patients With Scorpion Stings Admitted to the Pediatric Emergency Clinic.

Introduction Scorpion sting in children is still a serious health problem today. Children are at greater risk of developing severe cardiac, respiratory, and neurological complications because of their low body weight. In this study, we retrospectively evaluated the demographical changes, complaints, clinical findings, and laboratory results of scorpion sting cases admitted to the pediatric emergency department.  Materials and Methods The records of 72 patients who were followed up with the diagnosis of scorpion sting in the Dicle University Pediatric Emergency Department between 2013 and 2017 were retrospectively analyzed. Results The patients included in the study were between one and 15 years (7.64±4.04 years) and 43.1% were male, and 56.9% were female. While 65.3% of the cases lived in rural areas, 34.7% lived in the city center. The most common stung areas in the cases were the lower extremity (51.4%) and the upper extremity (34.7%). The most common complaints in the patients were 70.8% pain, 58.3% edema, 41.7% cold extremities, 23.6% sweating, 22.2% vomiting, and 12.5% excessive salivation. Of the cases, 71.4% had mild, 25.7% had moderate, and 2.9% had severe stages. Of the patients, 91.6% were given antivenom, 75.7% were given antihistamines, 74.3% were given steroids, 65.7% were given antibiotics, 64.3% were given analgesics, 44.3% were given tetanus vaccine, 2.8% were given erythrocyte suspension and 1.4% were given platelet suspension. In addition, 11.4% of the cases were given prazosin treatment. While 32.9% of the cases required intensive care, two patients died. A statistically significant difference was found between the glucose, urea, creatine, total protein, sodium, potassium, alanine aminotransferase, white blood cell count, red blood cell count, hemoglobin, hematocrit, neutrophil count values of the patients at admission and discharge. Conclusion Scorpion sting cases are still a significant health problem. The severe clinical course is more common in children. The management of patients with severe clinical forms is based on early recognition of the sting, antivenom serum administration, and cardiorespiratory and systemic support.

Comparative Analysis of Neutr ophil -to-l ympho cyte Ratio, Systemic Immune-Inflammation Index, and Prognostic Nutritional Index in Acute Myocardial Infarction Patients Treated with Percutaneous Coronary Intervention.

OBJECTIVE: Acute myocardial infarction constitutes one of the leading reasons for cardiac mortality. Therefore, early identification of high-risk patients provides better prognostic accuracy. This study aimed to investigate the prognostic significance of novel inflammatory biomarkers such as neutr ophil -to-l ympho cyte ratio, systemic immune-inflammation index, and prognostic nutritional index in acute myocardial infarction patients treated with percutaneous coronary intervention and to compare their predictive abilities with each other. METHODS: A total of 828 acute myocardial infarction patients treated with percutaneous coronary intervention were retrospectively analyzed. The inflammatory indices, such as neutr ophil-to-l ympho cyte ratio, systemic immune-inflammation index, and prognostic nutritional index, were calculated by admission blood tests. The study population was divided into 2 groups according to the occurrence of major adverse cardiac events, which were defined as all-cause mortality, non-fatal myocardial infarction, and cerebrovascular events. RESULTS: Multivariate Cox regression analysis determined prognostic nutritional index as an independent predictor of major adverse cardiac event and all-cause mortality (hazard ratio: 1.05, 95% CI: 1.02-1.07, P < .001 for major adverse cardiac event and hazard ratio: 1.05, 95% CI: 1.02-1.09, P = .002 for all-cause mortality). Receiver operating characteristic curves revealed that the predictive value of prognostic nutritional index with both regard to major adverse cardiac event and all-cause mortality was better than the systemic immune-inflammation index and neutr ophil -to-l ympho cyte ratio (by DeLong method, area under curvePNI vs. area under curveSII z test = 2.66, P = .008; area under curvePNI vs. area under curveNLR z test = 2.8, P = .006; area under curvePNI vs. area under curveSII z test = 2.58, P = .009; area under curvePNI vs. area under curveNLR z test = 3.28, P = .001; respectively). CONCLUSIONS: Prognostic nutritional index was demonstrated as an independent predictor of major adverse cardiac events and all-cause mortality and a more powerful prognostic index than other novel inflammatory biomarkers in acute myocardial infarction patients treated with percutaneous coronary intervention.

Relationship between leader-member exchange and burnout in professional footballers.

Numerous variables influence burnout, one of which is leader-member exchange. The present study was conducted to determine whether leader-member exchange quality affects burnout in professional footballers. The study used the Leader-Member Exchange-7 scale developed by Scandura and Graen ( 1984 ) to measure leader (coach)-member (player) exchange and Pines's ( 2005 ) abbreviated version of the burnout scale developed by Pines and Aronson ( 1988 ) to measure burnout. The data were obtained from the professional players (N = 107) of six football clubs in the Turkish Secondary Football League in western Turkey. The results demonstrated that quality of leader-member exchange significantly and inversely influenced burnout of professional footballers. The study also evaluated quality of leader-member exchange in terms of three strengths of relationship (low, fair, and high) between the coach and players. Contrary to expectations, the results revealed significant differences in burnout when comparing low versus fair quality and low versus high quality, while no significant difference in burnout was observed between fair and high quality.

Eating Behaviors in Early Childhood (1-5 Years) and Their Association With Sociodemographic Characteristics in Turkey.

Eating problems are common in childhood and being seen in 25%-45% of healthy children. The period following the first year of life up to five years is when eating problems are most frequently reported and also when the child acquires eating habits. Several studies have shown that eating behavior is affected by the family environment, and by parental eating habits and modes of feeding their children. The purpose of this study was to investigate the eating behavior characteristics of children in early childhood, to determine the frequency of problematic eating behaviors, and to compare these with the family's sociodemographic characteristics. The study consisted of 255 children aged 1-5 years, with no chronic disease, presenting to Izmir Tepecik Education and Research Hospital Child Health and Diseases Department general pediatric clinics between February and April, 2017, together with their parents. In the study, 39 questions were asked to parents related to children's demographic characteristics and eating behaviour. Problematic eating behavior was present in 43.9% of the study group. Analysis identified feeding bottle use, feeding with the use of an assistant object, eating lasting longer than half an hour, and the child not feeding itself as the most frequent eating problems. Malnutrition was present in 104 (65.8%) of the children with problematic eating behavior. Examination of unhealthy eating behavior in the light of the study findings showed no significant association between eating behaviors and variables such as type and time of delivery, maternal education level, maternal employment status, maternal age, or the number of children in the family. In terms of nutrition status, Turkey appears to exhibit problems associated with both developed and developing countries. Public nutrition in Turkey fluctuates significantly depending on the region, the season, socioeconomic levels, and differences between urban and rural settlements. Early-onset of eating-related problems can have a negative effect on children's subsequent physical, emotional, and social development. Determination in the early period of eating problems seen in children and investigation of the causes thereof is important in terms of identifying a potential solution. It is important to work with the family to that end, and for children to be followed-up by pediatricians at regular intervals.

RDW Value may Increase the Diagnostic Accuracy of MPS.

OBJECTIVES: As the feasibility of obtaining health care has improved in the last decade, there is an increase in the number of performing unnecessary coronary angiogram. Red Cell Distribution Width (RDW), which shows erythrocyte dispersion volume, is associated with coronary artery disease. The present study aims to evaluate the relationship between RDW value and the severity of coronary artery disease in patients who undergo myocardial perfusion scintigraphy (MPS) as an evaluation for coronary ischemia and after which patients had a coronary angiography. METHODS: This retrospective study included 452 patients diagnosed as stabile angina that had MPS to evaluate coronary ischemia and after which coronary angiography was performed. Complete blood count was obtained on the same day. Patients were first divided into two groups: patients with and without ischemia on MPS. Then, the group who had ischemia on the MPS where divided into another two groups: patients who had RDW values ≥13.5 and the others who had RDW value <13.5. Patients who had fixed perfusion defect, chronic kidney disease, thyroid dysfunction, hematological disease, those who use iron supplements, and those who had active infectious disease were excluded from this study. RESULTS: The basic characteristics were the same between study groups. We found that severe coronary vessel disease, single vessel, two vessels and three vessels diseases were higher in patients who had ischemia on the MPS and RDW values ≥13.5 (p-value were 0.032, 0.004, 0.042 respectively). RDW values ≥13.5 was found to be an independent predictor for the presence of severe coronary artery disease (p<0.001 OR: 3.55). CONCLUSION: Patients who have MPS for ischemic evaluation and RDW values of ≥ 13.5 were more severe coronary heart diseases. As a result, the findings suggest that using of RDW value is a cheap and feasible parameter that may prevent performing unnecessary coronary angiography for patients after MPS.

Comparing the Prognostic Value of Hematological Indices in Patients With ST Segment Elevation Myocardial Infarction: "A Head to Head" Analysis.

Although there are reviews and meta-analyses focusing on hematological indices for risk prediction of mortality in patients with ST segment elevation myocardial infarction (STEMI), there are not enough data with respect to direct to head-to-head comparison of their predictive values. We aimed to investigate which hematological indices have the most discriminatory capability for prediction of in-hospital and long-term mortality in a large STEMI cohort. We analyzed the data of 1186 patients with STEMI. In-hospital and long-term all-cause mortality was defined as the primary end point of the study. In-hospital mortality rate was 8.6% and long-term mortality rate 9.0%. Although the neutrophil to lymphocyte ratio (NLR) and age were found to be independent predictors of in-hospital mortality in the multivariate regression analyses; Cox regression analysis revealed that age, ejection fraction, red cell distribution width (RDW), and monocyte to high-density lipoprotein ratio (MHDLr) were independently associated with long-term mortality. Neutrophil to lymphocyte ratio had the highest area under curve value in the receiver operating characteristic curve analyses for prediction of in-hospital mortality. In conclusion, while NLR may be used for prediction of in-hospital mortality, RDW and MHDLr ratio are better hematological indices for long-term mortality prediction after STEMI than other most common indices.