Genetic Diversity and Population Structure of Wheat Stripe Rust Pathogen (Puccinia striiformis f. sp. tritici) in Turkey.

Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most important diseases threatening wheat production both in Turkey and worldwide. However, the underlying genetic dynamics of Pst populations are not fully known in Turkey. To determine the population genetic structure and migration network among regional Pst populations, a total of 140 Pst isolates collected from six geographical regions of Turkey from 2018 to 2020 were sampled and genotyped using 21 simple sequence repeat loci. A total of 70 multilocus genotypes were identified and classified into the three major genetic groups by Bayesian assignment. The highest genotypic diversity was detected in Southeastern Anatolia, showing its critical role as one of the source populations to trigger possible stripe rust epidemics. Analysis of molecular variance revealed the highest variation (90.25%) within isolates. The migration network generated by the number of effective migrants showed that the highest migration (1.0) was determined between Southeastern Anatolia and Central Anatolia, and considerable levels of migration (>0.2) were determined among the other regions, except for the Black Sea. Linkage equilibrium (P ≥ 0.05) was detected for many geographical regions, except for Marmara (P = 0.00) and the Mediterranean (P = 0.03), suggesting that reproduction of Pst populations is most likely sexual or mixed (sexual and clonal). To sum up, this is the first study on the genetic relationships and population genetic structure of the Pst population in Turkey, and these findings may provide critical information to develop management strategies for wheat stripe rust.

Phytochemical Profiling and Biological Activity of Achillea sintenisii Hub.-Mor.

Achillea (Asteraceae) species have been traditionally used for their different therapeutical properties. In this study, phytochemical composition of aerial parts of A. sintenisii which is endemic in Turkey was determined with Liquid chromatography/mass spectrometry/mass spectrometry (LC/MS/MS). To evaluate the wound healing potential, the cream formulation prepared from A. sintenisii was tested on the linear incision wound model in mice. In vitro enzyme inhibitory activity tests were performed on elastase, hyaluronidase, and collagenase. In the histopathological examination, angiogenesis and granulation tissue formation were significantly increased in A. sintenisii treatment groups compared to the negative control group. As a result of this study, it is thought that the enzyme inhibition and antioxidant activity of the plant may contribute to the wound healing process. According to LC/MS/MS analysis result, quinic acid (24.261 µg/mg extract) and chlorogenic acid (14.97 µg/mg extract) were identified as main constituents of the extract.

Determination of predictive risk factors for severe bronchiolitis.

BACKGROUND: The aim of this study was to determine the predictive risk factors for development of severe bronchiolitis in patients with acute bronchiolitis with no previous chronic disease. METHODS: Four hundred forty children aged 1-24 months hospitalised with acute bronchiolitis, were examined between February 2018 and February 2019 in this prospective study. RESULTS: Eighty-five cases were regarded as severe bronchiolitis and 355 as mild-moderate bronchiolitis. Statistically significant differences were observed between the severe and mild-moderate bronchiolitis groups in terms of weight-for-age z-scores, history of bronchiolitis, haemoglobin levels, and time elapsed between the onset of symptoms and admission. Weight-for-age z-scores, the mean time interval between the onset of symptoms and admission, and mean haemoglobin values were lower in the severe bronchiolitis group while the mean number of bronchiolitis attacks was higher than in the mild-moderate bronchiolitis group. Logistic regression analysis determined that a low weight-for-age z-score increased the risk of severe bronchiolitis development 0.56-fold (CI: 0.409-0.760), a short duration between the onset of symptoms and admission increased the risk 0.62-fold (CI: 0.519-0.735), a frequent history of bronchiolitis increased the risk 1.81-fold (CI: 1.135-2.968) and low haemoglobin levels increased the risk 0.72-fold (CI: 0.537-0.969). CONCLUSION: Low weight-for-age z-scores, a short duration between the onset of symptoms and admission, a high number of previous attacks and low haemoglobin levels were identified as independent parameters of severe bronchiolitis development.

A New Virulent Race of Wheat Stripe Rust Pathogen (Puccinia striiformis f. sp. tritici) on the Resistance Gene Yr5 in Turkey.

The gene Yr5 in wheat has generally been known to confer resistance to Puccinia striiformis f. sp. tritici races worldwide. However, a few reports indicated that some isolates of the stripe rust pathogen were virulent on the wheat genotypes with Yr5 in India, Australia, and China (Nagarajan 1986; Wellings and McIntosh 1990; Zhang et al. 2020). In April 2020, a stripe rust infection was observed on Triticum spelta 'Album' (TSA), the Yr5 donor, provided by Turkey Seed Gene Bank in a wheat breeding field at the experimental station of Akdeniz University in the Antalya province of Turkey. The sample was tested on the seedlings of the Yr single-gene lines in the Avocet S (AvS) background including Yr5 near-isogenic line (AvSYr5NIL), TSA, and susceptible bread wheat variety 'Morocco' according to the procedure reported by Wan et al. (2014), and found to be highly virulent on Morocco with infection type (IT) 9 and virulent on AvSYr5NIL and TSA with IT 7. To confirm this novel finding, single-pustule isolates derived from this sample were obtained from TSA and re-tested on the differentials and TSA. The Yr5-virulent isolate yielded similar infection types on these plants further verifying previous results. The single-pustule isolates were determined to be avirulent (Avr) (IT 0 to 6) on AvSYr1NIL, AvSYr8NIL, AvSYr9NIL, AvSYr10NIL, AvSYr32NIL, and AvSYr43NIL and virulent (Vr) (IT 7 to 9) on AvSYr5NIL, AvSYr6NIL, AvSYr7NIL, AvSYr17NIL, AvSYr24NIL, AvSYr27NIL, AvSYr44NIL, AvSYrSpNIL, and TSA. The isolates were identified as a new race and temporarily named TRVR20-5 based on its Avr/Vr pattern. Furthermore, to confirm the presence of Yr5, the genomic DNA of fresh leaves of AvSYr5NIL and TSA used in the virulence testing were isolated using NucleoSpin Plant II (Macherey-Nagel, Germany) according to the manufacturer's procedure. The genomic DNA samples were amplified with the primers STS-7 (5'-GTACAATTCACCTAGAGT-3') and STS-8 (5'-GCAAGTTTTCTCCCTATT-3') (Chen et al. 2003) using a thermal cycler (T-100, BioRad, USA), and the resulting PCR products were digested with DpnII and visualized on an agarose gel. AvSYr5NIL and TSA had the fragment linked to the resistance allele (308 bp) whereas AvS and Morocco had the fragment linked to the susceptible allele (181 bp). Thus, both wheat genotypes were confirmed to carry Yr5, and the new Pst race virulent to Yr5 was confirmed. To the best of our knowledge, this is the first report of a Pst race virulent to Yr5 in Turkey, where stripe rust epidemics have occured in 2 out of every 5 years with 1-5% crop losses in over 25% of the wheat growing areas (Chen 2020). In a nutshell, monitoring the Pst races virulent to Yr5 with a potential to cause devastating epidemics worldwide is crucial due to the fact that international wheat breeding programs have been using Yr5 to develop wheat cultivars with resistance to stripe rust.

Evaluation Using Spectral-Domain Optical Coherence Tomography of the Effects of Malnutrition on Ocular Parameters in Pediatric Patients.

SIGNIFICANCE: We determined decreases in choroidal thickness and retinal nerve fiber layer (RNFL) thickness in all quadrants. Our findings show that the choroid and RNFL are affected before the emergence of ocular symptoms in malnourished children. PURPOSE: We aimed to determine whether the RNFL, a component of the neuronal structure, and the choroid, supplying the retina, are affected in children with malnutrition using spectral-domain optical coherence tomography. METHODS: One hundred twenty-six malnourished patients without ocular symptoms, aged between 5 and 10 years, and 116 healthy children were included in the study. Age, sex, weight-for-age (WFA) z score, height-for-age z score, body mass index-for-age z score, and spectral-domain optical coherence tomography data were recorded. RESULTS: Average RNFL thickness was 96.5 µm (82.0 to 128.0 µm) in the malnutrition group and 111.0 µm (95.0 to 128.0 µm) in the control group (P < .001). Retinal nerve fiber layer thickness was statistically significantly lower in all quadrants in malnourished patients compared with the control group. Median choroidal thickness in the foveal center was 304.0 µm (250.0 to 375.0 µm) in the malnutrition group and 345.0 µm (280.0 to 403.0 µm) in the control group (P < .001). Choroidal thickness in all quadrants was also statistically significantly lower in malnourished patients. Positive correlation was determined between average RNFL thicknesses and WFA z score. Average RNFL thickness decreased as WFA z score decreased (r = 0.730 and P < .001). Positive correlation was also observed between choroidal thickness in the foveal center and WFA z score. Foveal center choroidal thickness decreased in line with WFA z score (r = 0.786 and P < .001). CONCLUSIONS: Our results show that the retinal nerve fiber layer and choroidal thickness decreased in malnourished children without clinically reported ocular symptoms. A decreased retinal nerve fiber layer and choroidal thickness may be an important clue to the prevention of retinal pathologies that may develop at later ages if the malnutrition is not addressed.

Identification of Durum Wheat Cultivars and Their Tetraploid Relatives with Low Cadmium Content.

In this study, 71 durum wheat cultivars (Triticum durum Desf.), 22 emmer wheat (Triticum dicoccum L.) and 11 wild emmer (Triticum dicoccoides L.) genotypes were genetically characterized to determine the alleles associated with high cadmium (Cd) content. After genotypic characterization, 14 cultivars selected among all genotypes with low and high Cd content were phenotyped by a pot experiment to verify the genotypic data. Identification of 32 durum wheat, one emmer wheat and four wild emmer genotypes showed that they have alleles associated with high Cd content, while 68 genotypes of which 39 durum wheat, 21 emmer wheat and 7 wild emmer cultivars had alleles associated with low Cd content, respectively. Moreover, phenotypic data obtained from pot experiment were similar to the molecular data. To sum up, the marker successfully classified durum wheat cultivars into either high or low accumulators and these results can be safely used in breeding programs to improve new durum wheat cultivars with alleles associated with low Cd content. Due to routine use of phosphorus fertilizers in agricultural areas and other anthropogenic factors related to Cd toxicity, new durum wheat cultivars with low Cd content should be urgently developed for safe production of macaroni or other types of wheat products for human and animal consumption.

Anti-inflammatory and antibacterial evaluation of Thymus sipyleus Boiss. subsp. sipyleus var. sipyleus essential oil against rhinosinusitis pathogens.

Thymus sipyleus Boiss. subsp. sipyleus var. sipyleus of the Lamiaceae, locally known as thyme scented lemon, which is an endemic taxon collected from Sivas in Anatolia, was investigated in this study due to its folk medicine use against rhinosinusitis. The aromatic characteristics of the plant material gave the idea for the detailed evaluation of the volatiles and essential oil thereof. Consequently, the oil was obtained by Clevenger type hydrodistillation followed by gas chromatography-flame ionization detector (GC-FID) and gas chromatography/mass spectrometry (GC/MS) analyses for phytochemical characterization. To confirm the folk medicinal use against sinusitis, in vitro antimicrobial activities of the essential oil was evaluated by agar diffusion, microdilution and vapour diffusion methods against selected rhinosinusitis associated strains such as Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), S. epidermidis, Streptococcus pyogenes, S. pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae and Moraxella catarrhalis. Additionally, the in vitro anti-inflammatory activity was evaluated by 5-lipoxygenase (5-LOX) inhibitory effect of the essential oil spectrophotometrically. Furthermore, the composition of the volatiles of the vapour phase of the oil was determined by headspace-solid phase microextraction (HS-SPME-GC/MS) after 15 min and 24 h in accordance with antimicrobial vapour diffusion method conditions, respectively. According to the analytical results, the main component was determined as thymol (66.2%). Whereas in the HS-SPME method p-cymene (26.1%) and γ-terpinene (26%) were identified as the main volatile components within the 15. min., and thymol (75.3%) after 24 h, respectively. The antibacterial activity against rhinosinusitis pathogens varied between 160 and 1250 µg/mL minimum inhibitory concentrations, with the best inhibitory effects observed against the S. aureus, S. pyogenes and M. catarrhalis. The anti-inflammatory activity of the oil was determined as 12.1 ±â€¯1.8% in 100 µg/mL. The results showed the in vitro antimicrobial and anti-inflammatory potential of the oil also in vapour phase against sinusitis supporting the traditional use.

Molecular and agro-morphological characterization of ancient wheat landraces of turkey.

BACKGROUND: Turkey is one of the important gene centers for many crop species. In this research, some ancient wheats such as tetraploid and diploid hulled wheats together with hexaploid tir wheats (Triticum aestivum ssp. leucospermum Korn.) landraces mainly adapted to harsh winter conditions of Eastern Anatolian region of Turkey were characterized at agro-morphological and molecular level. Totally 50 hulled wheat population from Kastamonu, Konya and Kayseri provinces and 15 tir wheats from Kars provinces of Turkey were in-situ collected for characterization in 2013. Some quantitative and qualitative traits of each population were determined. RESULTS: Twenty three hulled wheat population collected from Kastamonu province were distinguished into nine emmer and 14 einkorn wheats at morphological level. Additionally, Konya, Kayseri and Kars population were characterized as einkorn, emmer and tir wheat, respectively. Among the evaluated traits, protein ratios of hulled wheats were strikingly higher than registered cultivars. All the populations were also examined by molecular level by using fluorescently labelled 11 polymorphic SSRs primers. The primers exhibited 104 bands, ranging from 6 to 16 with a mean value 9.45 per loci. The clustering analysis separated the germplasm into two clusters which were also divided into two subclusters based on genetic similarity coefficient. Sixty-five population and five checks were analyzed to estimate mean number of alleles (N), expected and observed heterozygoties (He and Ho), polymorphism information content (PIC), Wright fix index (F), genetic deviation from Hardy-Weinberg expectation (Fit-Fis) and genetic variation (Fst) were determined as 9.45, 0.71, 0.07, 0.67, 0.90, 0.39, 0.87 and 0.39, respectively. A clear genetic deviation from Hardy - Weinberg expectation was observed among population in particular. These results showed considerable genetic variation among landraces rather than within population. CONCLUSIONS: These molecular information has revealed genetically diverse einkorn, emmer wheat and tir wheat population could be used as parents for further breeding studies in both Turkey and abroad. Furthermore, the molecular analysis has also generally discriminated the germplasm into ploidy level.

Antibacterial resistance patterns of pediatric community-acquired urinary infection: Overview.

BACKGROUND: Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community-acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics. METHODS: A total of 158 children with positive urine culture were included in the study. Antibiotic susceptibility testing was performed with Vitek 2 Compact for 28 commonly used antimicrobials. RESULTS: Mean age was 3.36 ± 3.38 years (range, 45 days-15 years). Escherichia coli (60.1%), and Klebsiella spp. (16.5%) were the most common uropathogens. For all Gram-negative isolates, a high level of resistance was found against ampicillin/sulbactam (60.1%), trimethoprim/sulfamethoxazole (44.2%), cefazolin (36.2%), cefuroxime sodium (33.5%), and amoxicillin/clavulanate (31.5%). A low level of resistance was noted against cefepime (8.7%), ertapenem (4.6%), norfloxacin (1.3%), and meropenem (0.7%). There was no resistance against amikacin. CONCLUSIONS: There is high antibiotic resistance in children with UTI. The patterns of uropathogen antimicrobial resistance vary in susceptibility to antimicrobials depending on region and time. Thus, the trends of antibiotic susceptibility patterns should be analyzed periodically to select the appropriate regimen for UTI treatment.

Choroidal Thickness in Children with Beta Thalassemia Major.

PURPOSE: The purpose of this study was to determine whether there are differences in choroidal thickness in children with beta thalassemia major (ß-TM). METHODS: Thirty-five patients with ß-TM and 38 healthy children aged between 3 and 16 years participated in the study. After complete eye examinations were conducted on the participants, choroidal thickness measurements were performed using optical coherence tomography. Correlations between choroidal thickness and laboratory and clinical parameters, such as age, sex, hemoglobin and ferritin levels, duration of disease, type and duration of chelating therapy, visual acuity, intraocular pressure, central corneal thickness, and axial length were also evaluated. RESULTS: The mean ages for the study group and for the control group were 8.2 ± 2.7 and 7.9 ± 2.4 years, respectively. There were no statistical differences between groups in terms of visual acuity, intraocular pressure, central corneal thickness, or axial length (p > 0.05). Choroidal thicknesses at the foveal center were 286 ± 33 µm in ß-TM patients and 335 ± 423 µm in the healthy control children. Choroidal thicknesses at each point within the horizontal nasal and temporal quadrants were thinner in the ß-TM group. There was a positive correlation between choroidal thickness and hemoglobin levels and a negative correlation between choroidal thickness and ferritin levels (r = 0.924, p < 0.001 and r = -0.947, p < 0.001, respectively). There was no correlation between clinical or ocular characteristics and choroidal thickness. CONCLUSIONS: Choroidal thickness was significantly thinner in all quadrants in children with ß-TM. This thinning of the choroid may be the reason for the development of eye disorders in older patients with ß-TM.

Is there a relationship between low vitamin D and rotaviral diarrhea?

BACKGROUND: For children under 5 years of age, 1700 000 000 episodes of diarrhea are seen worldwide, and death occurs in 700 000 of these cases due to diarrhea. Rotavirus is an important cause of diarrhea in this age group, and many studies have shown that vitamin D plays a pivotal role in the immune system, as well as in antimicrobial peptide gene expression. In addition, lower vitamin D has been correlated with higher rates of infectious diseases such as respiratory tract infection, tuberculosis, and viral infection. METHODS: Seventy patients with rotaviral diarrhea and 67 healthy patients were enrolled in this study. Serum 25-hydroxy vitamin D(3) (25(OH)D(3)), parathormone, calcium, phosphate, alkaline phosphatase, complete blood count parameters, and C-reactive protein were compared between pre-school children hospitalized due to rotaviral diarrhea and healthy children. Additionally, birthweight, feeding habits in the first 6 months of life, vitamin D and multivitamin supplements, and rotaviral vaccinations were also evaluated in each group. RESULTS: There were no differences between the groups with regard to gender and age, but 25(OH)D(3) was significantly different: 14.6 ± 8.7 ng/mL in the rotaviral diarrhea patients versus 29.06 ± 6.51 ng/mL in the health controls (P < 0.001), and serum 25(OH)D(3) <20 ng/mL (OR, 6.3; 95%CI: 3.638-10.909; P < 0.001) was associated with rotaviral diarrhea. CONCLUSIONS: Low vitamin D is associated with rotaviral diarrhea. This is the first study in the literature to show this, and this result needs to be repeated in larger controlled clinical studies.

Is the mean platelet volume a predictive marker for the diagnosis of acute pyelonephritis in children?

BACKGROUND: Acute pyelonephritis (APN) can lead to renal scar formation, high blood pressure, and end-stage renal failure. Prompt and early diagnosis of APN is important for preventing future complications. Our goal was to study the mean platelet volume (MPV) as a predictor of APN in children. METHODS: The records of 43 patients with APN and 51 patients with a lower urinary tract infection (UTI) were investigated prospectively. APN was confirmed using radioactive nuclide 99mTc-DMSA scanning. The white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), and MPV of both groups were measured and compared. RESULTS: The WBC count, MPV and ESR values, and the serum concentration of CRP were higher in the APN group than in the lower UTI group (p < 0.05). In the children with APN, the optimal cut-off value for the MPV was 8.2 fl [area under the curve (AUC): 0.906], with sensitivity of 81.4 % and specificity of 86.3 %. The MPV was associated with APN (p = 0.001), and the sensitivity and specificity of the MPV for the diagnosis of APN were higher than those of the other inflammation markers. MPV > 8.2 fl yielded an adjusted OR of 7.8 (95 % CI 3.3-18.4, p < 0.001) for APN. MPV > 8.2 fl was significantly associated with late renal scar formation (adjusted OR 5.7, 95 % CI 2.3-13.8, p < 0.001). CONCLUSION: The MPV is a fast and reliable measurement with considerable predictive value for the diagnosis of APN and renal scars, and its predictive capacity is better than that of CRP, ESR, and WBC values.

Phytochemical analyses and effects of Alchemilla mollis (Buser) Rothm. and Alchemilla persica Rothm. in rat endometriosis model.

PURPOSE: The aim of the present study is to evaluate the treatment potential of Alchemilla mollis (Buser) Rothm. and Alchemilla persica Rothm. in the experimentally induced endometriosis model in rats. METHODS: Endometriosis was surgically induced in rats by autotransplanting endometrial tissue to abdominal wall. Thirty-six rats were randomly divided into six groups. The groups were orally treated with the methanol:water (80:20) extracts of aerial parts and roots of A. mollis and A. persica. Buserelin acetate (20 mg) was used as the reference drug. The phytochemical contents of the most active extracts were determined by high performance liquid chromatography. RESULTS: The cystic formation was determined to be significantly decreased with the aerial part extract of A. mollis. A reduction in the endometrioma was also determined for the aerial part extract of A. persica group. However, significant reduction on the levels of cytokine were recorded for the A. mollis aerial part extract group. Therefore, the phytochemical contents of the aerial part extracts of A. mollis. and A. persica were analyzed. CONCLUSION: The results of the present study revealed that the aerial part extracts of A. mollis and A. persica could be beneficial in the treatment of endometriosis.

Reference ranges of kidney dimensions in term newborns: sonographic measurements.

BACKGROUND: Ultrasonographic measurement of kidney dimensions is important in evaluation of renal disease during the neonatal period, when renal abnormalities are common and renal size rapidly changes with age. OBJECTIVE: To determine the reference ranges of kidney dimensions in newborns and to provide a reference chart for daily practice. MATERIALS AND METHODS: In this prospective study, kidney dimensions were evaluated in 385 healthy newborns with a gestational age ≥37 weeks. Each neonate seen at an obstetrics clinic and neonatal intensive care unit was examined with sonography within the first week of life. Relationships of all dimensions with gender, gestational age, height and weight were statistically analyzed. RESULTS: All dimensions of the kidneys were smaller in girls than in boys (P < 0.05). The dimensions of the left kidney were larger than those in the right kidney in both genders (P < 0.01). Longitudinal and anteroposterior dimensions of the right and left kidneys showed no correlation with the gestational age in either gender. The dimensions correlated with the height in boys (P < 0.01), while no correlation was seen between the dimensions and height in girls (P < 0.05). Weight had the best correlation with all dimensions in both genders. CONCLUSION: The reference values of kidney lengths and diagrams from this study may be useful in the sonographic evaluation of kidneys in newborns.

The Diagnostic Efficacy of and Requirement for Postnatal Ultrasonography Screening for Congenital Anomalies of the Kidney and Urinary Tract.

BACKGROUND: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. METHODS: In this retrospective cohort study, we reviewed the records of term infants between six weeks and three months of age who underwent urinary tract ultrasonography during routine pediatric care. RESULTS: Congenital anomalies of the kidneys and urinary tract were detected on prenatal ultrasonography in 75 of the 2620 patients included in the study. Congenital anomalies of the kidneys and urinary tract were detected via postnatal USG in 46 (1.8%) of 2554 patients without anomalies on prenatal USG screening. The most common anomaly was hydronephrosis (69.6%). Thirty-two cases of hydronephrosis, three cases of renal agenesis, four cases of horseshoe kidney, one case of MCDK, and two cases of duplex systems which were not detected on prenatal USG were detected on postnatal USG. On the other hand, 29 (1.1%) cases with mild or moderate hydronephrosis on prenatal ultrasonography did not have hydronephrosis on postnatal ultrasonography. CONCLUSIONS: In our study, approximately one-third of the cases of hydronephrosis, unilateral renal agenesis, duplex systems, horseshoe kidney, and ectopic kidney were not detected in prenatal ultrasonography screening. Therefore, we believe that in addition to prenatal ultrasonography screening, postnatal ultrasonography screening of all children for urinary tract anomalies would be beneficial.

Ultrasonography Results in First Urinary Tract Infection During Childhood: Which Age Group Should Be Screened?

OBJECTIVES: To determine the frequency of urinary system anomaly in children aged 0-18 y suffering from first urinary tract infection (UTI) and to establish which age group requires urinary ultrasonography (USG) screening. METHODS: Age and gender, urine culture, urinary USG, and urological imaging results among 247 children in the 0-18 y age group with a first diagnosis of UTI were investigated retrospectively. RESULTS: Anomaly was detected at USG in 68 (27.5%) of the 247 patients suffering from first UTI. The most common anomaly was hydronephrosis. Non-E. coli micro-organisms were the pathogenic agents in 61.8% of patients with anomalies detected at USG. Being in the 0-5 y age group (OR: 0.524, 95% CI 0.284-0.970, p = 0.040) and presence of atypical UTI (OR: 4.746, 95% CI: 1.675-13.450, p = 0.003) emerged as independent predictive markers of severe urinary system pathologies on multiple regression analysis. CONCLUSION: Based on the data in the present study, routine USG screening is recommended for children suffering from first UTI under the age of 5 y and for the children suffering from atypical UTI at all ages.

Evaluation of Patients with Acute Respiratory Distress Syndrome Followed on Mechanical Ventilator in a Tertiary Pediatric Intensive Care and the Factors That May Be Associated with Death in These Patients.

OBJECTIVE: We aimed to evaluate the clinical, demographic, and laboratory characteristics of the patients followed up with pediatric acute respiratory distress syndrome in our pediatric intensive care unit and to determine the factors that have an effect on the outcomes. MATERIALS AND METHODS: The medical records of 40 patients with acute respiratory distress syndrome who were followed up on mechanical ventilators in the pediatric intensive care unit of Adiyaman University were retrospectively scanned. From the medical records, the demographic data, clinical features, and laboratory characteristics were recorded. RESULTS: Eighteen of the patients were female and 22 were male. The mean age was 45.25 ± 56.63 months. A total of 27 (67.5%) of the patients were classified as pulmonary and 13 (32.5%) as extrapulmonary acute respiratory distress syndrome. Sixteen (40%) patients were followed in pressure-controlled mode only, 2 (5%) patients in volume-controlled mode only, and 22 (55%) patients in alternate modes. A total of 17 (42.5%) patients died. The median pediatric index of mortality, pediatric index of mortality-II, pediatric risk of mortality, and pediatric logistic organ dysfunction score values of the surviving patients were significantly lower than the dead patients. Median aspartate aminotransferase (P = .003) and lactate dehydrogenase (P = .008) values were found to be significantly higher in patients who died, while median pH values (P = .049) were found to be lower. The median length of stay in pediatric intensive care unit and duration of mechanical ventilators were significantly shorter in patients who died. Also, the median pediatric index of mortality, pediatric index of mortality-II, pediatric risk of mortality, and pediatric logistic organ dysfunction values of pulmonary acute respiratory distress syndrome patients were significantly lower than those of extrapulmonary acute respiratory distress syndrome patients. CONCLUSION: Despite advances in follow-up and management, mortality due to acute respiratory distress syndrome is still high. Mechanical ventilator duration, length of stay in pediatric intensive care unit, some mechanical ventilator parameters, mortality scores, and laboratory tests were associated with mortality. Alternatively, mechanical ventilator applications may reduce mortality rates.

The haemodynamic effects of umbilical cord milking in term infants: a randomised controlled trial.

Introduction: Umbilical cord milking (UCM) is a method that allows for postnatal placental transfusion. The benefits of UCM have been demonstrated in some studies, but knowledge about its haemodynamic effects in term infants is limited. The aim of this study was to evaluate the haemodynamic effects of UCM in term infants. Methods: In this prospective, randomised controlled study, 149 healthy term infants with a birth week of ≥37 weeks were randomly assigned to either the UCM or immediate cord clamping (ICC) group. Blinded echocardiographic evaluations were performed in all the neonates in the first 2-6 h. Results: Superior vena cava (SVC) flow measurements were higher in the UCM group compared to the ICC group (132.47 ± 37.0 vs. 126.62 ± 34.3 mL/kg/min), but this difference was not statistically significant. Left atrial diameter (12.23 ± 1.99 vs. 11.43 ± 1.78 mm) and left atrium-to-aorta diastolic diameter ratio (1.62 ± 0.24 vs. 1.51 ± 0.22) were significantly higher in the UCM group. There were no significant differences in other echocardiographic parameters between the two groups. Conclusion: We found no significant difference in the SVC flow measurements in term infants who underwent UCM versus those who underwent ICC. This lack of significant difference in SVC flow may be explained by the mature cerebral autoregulation mechanism in term neonates.

Investigation of Serum Interleukin 6, High-Sensitivity C-Reactive Protein and White Blood Cell Levels during the Diagnosis and Treatment of Paediatric Appendicitis Patients Before and during the COVID-19 Pandemic.

Introduction: In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. Materials and Methods: A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared. Results: WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group. Conclusions: Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively.

An Evaluation of Choroidal and Retinal Nerve Fiber Layer Thicknesses Using SD-OCT in Children with Childhood IgA Vasculitis.

Background: We aimed to evaluate choroidal and retinal nerve fiber layer (RNFL) thicknesses in children undergoing the childhood IgA vasculitis (IgAV). Methods: Fifty-two patients with IgAV aged 1−6 years and 54 healthy children were included. Cases' age, sex, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RNFL thicknesses, and choroidal thickness values were recorded. Results: Median foveal center choroidal thickness was 374.0 µm (315.0 to 452.0 µm) in the IgAV group and 349.5 µm (285.0 to 442.0 µm) in the control group (p = 0.001). Median average RNFL thickness was 110.0 µm (91.0 to 134.0 µm) in the IgAV group and 104.0 µm (89.0 to 117.0 µm) in the control group (p < 0.001). Choroidal and RNFL thicknesses were significantly greater in all quadrants in the IgAV group than in the control group. No correlation was determined between ESR or CRP and foveal center choroidal and average RNFL thicknesses. Conclusions: Our findings show that choroidal and RNFL thicknesses increased significantly in children undergoing childhood IgA vasculitis compared to the healthy control group. These findings show that the choroid and RNFL are also affected by the inflammatory process in IgAV, which is a systemic vasculitis. We think that the choroidal and RNFL thicknesses can be used as a biomarker for childhood IgAV.