Estimated exposure to bisphenol A in breastfed and breastfed plus formula-fed infants in Turkey: a comparison study.

This study aimed to estimate and compare dietary exposure to bisphenol A (BPA) in exclusively breastfed (EBF) and breastfed plus formula-fed (BF + FF) infants. A total of 70 mothers and their 0-6 month-old infants (40 in the EBF group and 30 in BF + FF group) were included in the study. After the questionnaire form was applied to the mothers, maternal breast milk, infant formula, and infant urine were collected from mother-infant dyads. Total BPA levels in breast milk, infant formula, and infant urine samples were analyzed by the high-pressure liquid chromatography (HPLC). While BPA was detected in 92.5% of the breast milk samples in the EBF group (mean ± SD = 0.59 ± 0.29 ng/mL), BPA was detected in all of the breast milk samples in the BF + FF group (mean ± SD= 0.72 ± 0.37 ng/mL) (p < 0.05). Similarly, 100% of the infant formula samples in the BF + FF group had detectable levels of BPA (mean ± SD = 7.54 ± 1.77 ng/g formula). The mean urinary BPA levels in the EBF infants (4.33 ± 1.89 µg/g creatinine) were not statistically different from the BF + FF infants (5.81 ± 0.11 µg/g creatinine) (p > 0.05). The average daily BPA intake in EBF infants (0.18 ± 0.13 µg/kg body weight (bw)/day) was found to be significantly higher than in BF + FF infants (0.12 ± 0.09 µg/kg bw/day) (p < 0.05). The estimated dietary intakes of BPA for infants in both groups were below the temporary tolerable daily intake (t-TDI) (4 µg/kg bw/day). Consequently, BPA intake of EBF and BF + FF infants were within safe daily limits during the first six months of life.

Risk factors, complications and outcome of cholelithiasis in children: A retrospective, single-centre review.

AIM: The aim of this study was to evaluate the clinical presentation, risk factors, complications, treatment and outcomes of cholelithiasis in children. METHODS: Children with cholelithiasis were reviewed for demographic information, predisposing factors, presenting symptoms, laboratory findings, complications, treatment and outcome, retrospectively. RESULTS: A total of 254 children with cholelithiasis (mean age: 8.9 ± 5.2 years) were recruited to the study. Girls (52.8%) were significantly older than boys (P < 0.001). Symptomatic patients (59%) were significantly older than asymptomatic patients (P = 0.002). Abdominal pain was the most frequent symptom. No risk factors were identified in 56.6% of the patients. Ceftriaxone (20%) was the most commonly associated risk factor. At presentation, at least one of the following complications was seen in 14.1% of patients: cholecystitis (10.9%), obstructive jaundice (2.7%), pancreatitis (1.96%) and cholangitis (1.2%). There was no relationship between gallstone size and symptoms, aetiological factors and complications. The cholelithiasis dissolution rate was higher in younger children (P = 0.032), in those with biliary sludge (P < 0.0001) and ceftriaxone-related cholelithiasis (P < 0.001). Haemolytic anaemia (P = 0.001) and older age (P = 0.002) were associated with stable stones. Ursodeoxycholic acid was administered to 94.4% of patients at presentation. Twenty-nine patients underwent cholecystectomy, and seven patients underwent endoscopic retrograde cholangiopancreotography. Patients who were symptomatic at presentation had significantly more frequent symptoms at follow-up (P < 0.001) CONCLUSIONS: Dissolution rate of cholelithiasis was higher in younger children, biliary sludge formation and ceftriaxone-related cholelithiasis but lower in older children and haemolytic anaemia-related cholelithiasis.

Effectiveness of pandemic influenza A/H1N1 vaccine for prevention of otitis media in children.

UNLABELLED: Our aim was to evaluate effectiveness of pandemic influenza A/H1N1 vaccine in preventing acute otitis media (AOM) and/or otitis media with effusion (OME), in a randomized, prospective and single-blind study conducted in the children aged of 6-60 months. This study was done between December 1, 2009 and April 30, 2010 during the pandemia between June 2009 and May 2010. On the healthy children, vaccinated against pandemic influenza A/H1N1 and age-matched unvaccinated controls, the rate of AOM, OME, and any otitis media (OM) attack (sum of AOM and OME attacks) confirmed by otoscopic and tympanometric examination, and their associations with risk factors were looked for. Otoscopic and tympanometric evaluation was done twice within the follow-up period of 4-8 weeks. Totally 46 vaccinated and 46 unvaccinated healthy children were enrolled. No difference in rates of AOM, OME, or OM was found between vaccinated and unvaccinated children. But logistic regression analysis revealed that unvaccinated children had 2.9-folds more risk for OME and OM, but not for AOM. Further, male gender and bottle feeding and/or using pacifier revealed significant relationships with AOM. CONCLUSION: We conclude that pandemic influenza A/H1N1 vaccine prevented OME rather than AOM attacks in children with 6-60 months of age.

Syrian refugee mothers' knowledge levels of childhood wellness: A program evaluation.

BACKGROUND: Children are most affected by migration and wars. The health of child asylum seekers is adversely affected due to poor nutrition, malnutrition, insufficient vaccinations, and a lack of preventive health-care services (PHCS). The aim of this study was to determine the knowledge levels of the refugee mothers of child wellness monitoring, child vaccinations, and the importance of breastfeeding before and after implementation of an educational program. MATERIALS AND METHODS: A questionnaire consisting of 12 statements about the importance of child wellness monitoring, child vaccinations, and breastfeeding was prepared and translated into Arabic. Refugee mothers were asked to complete the questionnaire before and after the education program. RESULTS: Thirty-one (72.1%) of the 43 participating mothers had their children vaccinated regularly. Vitamin D supplementation was given to 58.1%, and 23.1% were started on iron supplementation. The rate of vitamin D supplementation was higher in the literate mothers (P = 0.010). The least correctly answered statement before the education program was related to iron supplementation (n = 24, 55.8%). The mean (standard deviation) number of correct answers given by the participating mothers to the 12 statements before the seminar was 9.16 (±2.05), this increased to 11.16 (±0.99) after the seminar. CONCLUSION: The resultes of this study show that refugee mothers' knowledge levels about vitamin D and iron supplementation are quite low. Their knowledge levels can be increased in the short term by providing information in the mothers' native languages.

Evaluation of Syrian refugees who received inpatient treatment in a tertiary pediatric hospital in Turkey between January 2016 and August 2017.

Background: Turkey is the leading country among those that accept Syrian refugees. This study aimed to determine the density of Syrian refugees who received inpatient treatment at Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital between January 2016 and August 2017. Methods: Syrian refugees' gender, age, place of birth, duration of hospitalization, admission diagnosis and services required as an inpatient were recorded from the registration system. Admission diagnoses were grouped according to the 'International Statistical Classification of Diseases and Related Health Problems'. Results: A total of 623 Syrian patients were included in this research. The median age of inpatients was 25.1 months; 58% (362/623) were male and 41% (257/623) were born in Turkey. The mean duration of hospitalization was 3 d. The highest number of admissions was observed in January. Pediatric emergency (17.7%) and pediatric surgery (12%) departments were the services with the highest number of admissions in this hospital. The most common admission reasons were found to be respiratory tract diseases, acute gastroenteritis and burns. Conclusions: Syrian refugees received inpatient treatment in services with different diagnoses. Preventive health measures targeting Syrian refugees may provide treatment at an earlier stage and reduce the rate of hospitalization.

Effects of seasonal variation and maternal clothing style on vitamin D levels of mothers and their infants.

In Turkey, vitamin D deficiency has been seen in children as well as in their mothers. We assessed the vitamin D status of 83 infants and their mothers, categorized into four groups according to season and mothers' clothing style. We measured serum levels of 25-hydroxy vitamin D, calcium, inorganic phosphorus and alkaline phosphatase in each mother-infant pair. In the summer, the rate of vitamin D deficiency was higher in mothers who wore clothing that covered nearly all of the body (55%) than in mothers whose clothing covered less of the body (13.6%) (p=0.016). In the winter, nearly half of both groups of mothers had vitamin D deficiency or insufficiency, and there were no significant differences based on their clothing style (p>0.05). In all groups of infants, vitamin D deficiency and insufficiency rates were found to be very low. It seems that 400 IU/daily vitamin D intake is adequate for infants in Turkey; for mothers, we propose vitamin D supplementation during the pregnancy and lactation period.