Raccoon Eyes Presentation in a Child Diagnosed With Acute Lymphoblastic Leukemia: A Case Report.

Raccoon's eyes (periorbital ecchymosis) may present as the first sign in patients with skull base/base/facial fractures and tumors. In childhood, orbital metastases of neuroblastoma should be considered in the absence of trauma history. Herein, we report a 3-year-old girl diagnosed with acute lymphoblastic leukemia who presented with periorbital ecchymosis. To the best of our knowledge, this is the first pediatric patient with acute lymphoblastic leukemia in the literature who presented with raccoon eyes.

Differences between adult and pediatric chronic spontaneous urticaria from a cohort of 751 patients: Clinical features, associated conditions and indicators of treatment response.

BACKGROUND: Chronic spontaneous urticaria (CSU) is a common disease both in the pediatric and in the adult population. However, there are differences between the two patient populations with respect to etiological factors, comorbidities, and treatment responses. Our aim was to determine differences between pediatric and adult CSU in terms of clinical characteristics, laboratory parameters, comorbidities, response to treatment, and indicators of response. METHODS: A retrospective analysis of CSU patients was performed. Data regarding differences between pediatric and adult CSU patients were analyzed. Indicators of treatment response were determined separately in both pediatric and adult patients. RESULTS: Of 751 CSU patients (162 pediatrics and 589 adults), female dominancy (48.8% vs. 69.6%) and rate of angioedema (19.1% vs. 59.8%) were lower, and disease duration (5 months vs. 12 months) was shorter in pediatric patients. Anti-TPO positivity (24.7% vs. 9%), elevated CRP (46.5% vs. 11.1%), eosinopenia (38.5% vs. 18.1%), and skin prick test positivity (39.3% vs. 28.8%) were significantly more frequent in adult patients. Response to antihistamines was higher in the pediatric group, and only 7% used omalizumab versus 20.8% in the adults. The comparisons were also performed between <12-year and ≥12-year patients and yielded similar results. CONCLUSION: Pediatric CSU shows distinct characteristics such as lower incidence of angioedema and antithyroid antibodies, and it responds better to antihistamines. These suggest that CSU becomes more severe and refractory in adolescents and adults. Adolescent CSU shows features similar to adult CSU rather than pediatric CSU.

Neonatal portal vein thrombosis: risk factors, diagnosis, treatment recommendations and review of the literature.

BACKGROUND: Neonatal portal vein thrombosis (PVT) is currently more commonly encountered as a result of advances in diagnostic tools and increase in invasive interventions. METHODS: In this study, 11 premature and 12 term infants diagnosed with PVT were retrospectively evaluated for clinical and laboratory characteristics, umbilical catheterization procedure, PVT location, risk factors, treatments, and long-term outcomes. RESULTS: Median age of the patients at diagnosis was 10 days (range 3-90 days), and 69.6% of patients were girls. Of the 23 patients, 87% had left PVT and, 91.3% had at least one thrombosis risk factor, which was sepsis in 73.9% of patients, and presence of umbilical venous catheter in 87%. Totally, 59.1% of PVTs were completely resolved in a median follow-up of 7 months (1 month to 12 months), and 78.3% of these patients had no anticoagulant therapy (ACT). Partial thrombus resolution was achieved in 9 patients (40.9%). Five patients (%21) received ACT. Overall, 34.8% of patients had long-term complications. neonatal PVT is most commonly reported in the left portal vein and there is no evidence for the impact of ACT on reducing the short- or long-term complications. Well designed and larger studies are necessary to clarify this issue, which can facilitate developing appropriate management algorithms. CONCLUSION: Neonatal PVT is most commonly reported in the left portal vein and there is no evidence for the impact of ACT on reducing the short- or long-term complications. Well designed and larger studies are necessary to clarify this issue, which can facilitate developing appropriate management algorithms.

Comparison of the ability of HOMA-IR, VAI, and TyG indexes to predict metabolic syndrome in children with obesity: a cross-sectional study.

BACKGROUND: The increasing trend in childhood obesity needs to be closely monitored and intervened due to long-term health issues such as metabolic syndrome, cardiovascular diseases, hypertension, and type 2 diabetes. We aimed to determine and compare the cut-off values for the visceral adiposity index (VAI), triglyceride-glucose index (TyG), and HOMA-IR for predicting metabolic syndrome (MetS). METHODS: This population-based cross-sectional study was conducted in May 2019 in Samsun, Turkey. The study included 169 children with obesity aged 9 and 10 years. After anthropometric and clinical evaluation, fasting blood samples were collected from the children. The areas under the curve of the visceral adiposity index, triglyceride-glucose index, and HOMA-IR were compared by receiver-operating-characteristic (ROC) analysis in predicting the MetS. RESULTS: The total prevalence of MetS was 21.3% in children with obesity, and it was two times higher in girls than in boys. The mean values of TyG and VAI were significantly different in those who have and have not MetS in both genders. However, the HOMA-IR index was higher only in girls with MetS and did not differ in boys by having MetS. The VAI and the TyG index both had statistically significant cut-off values in both sexes and a larger ROC area than the HOMA-IR index in predicting MetS. CONCLUSIONS: The VAI and TyG index are effective indicators in assessing the MetS risk in children with obesity. Both indexes can be considered useful tools in pediatric research and the evaluation of interventions. However, the HOMA-IR index formula needs to be developed taking into account age, gender, and ethnicity.

Incidence and risk factors for retinopathy of prematurity in premature, extremely low birth weight and extremely low gestational age infants.

BACKGROUND: The aim of the study was to determine the incidence and risk factors of retinopathy of prematurity (ROP) in premature, extremely low birth weight (BW, ELBW) and extremely low gestational age (GA, ELGA) infants. METHODS: The medical records of preterm infants who were screened for ROP between January 2012 and December 2020 were retrospectively reviewed. Only one eye of each infant with higher grade ROP was included in the study. BW; GA; medical characteristics; the presence, severity, and need for treatment of ROP were recorded. Infants were divided into groups according to BW (≤1000 g, 1001-1750 g, > 1750 g) and GA (≤25w, 26-28w, 29-31w, 32-34w, ≥35w) and data were analyzed. RESULTS: Data of 2186 infants were evaluated. The overall incidences of any stage ROP and ROP requiring treatment were 43.5 and 8.0%, respectively. These rates were 81.1 and 23.9% in ELBW (≤1000 g) infants and were 92.9 and 64.3% in ELGA (≤25w) infants, respectively. The rates of ROP, the median duration of oxygen therapy and systemic diseases increased significantly as BW and GA decreased. The median duration of oxygen therapy and the rates of sepsis, pulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) were statistically higher in infants with ROP compared to those without ROP (p < 0.001). Multivariate regression analysis demonstrated that low BW and GA; prolonged duration of oxygen therapy; presence of PDA and necrotizing enterocolitis (NEC) were important risk factors for ROP. CONCLUSIONS: ELBW and ELGA infants develop higher rates of ROP and severe ROP. Prolonged duration of oxygen therapy, the presence of concomitant neonatal sepsis, BPD, IVH, PDA, and NEC further increases the risk of ROP.

Investigating the Effects of Protective Face Masks on the Respiratory Parameters of Children in the Postanesthesia Care Unit During the COVID-19 Pandemic.

PURPOSE: The purpose of this study was to investigate the effect of protective face mask usage during the postoperative period on carbon dioxide retention in children during the COVID-19 pandemic. DESIGN: This study was designed as a prospective, randomized trial including 40 ASA I-II patients aged 3 to 10 years who were scheduled for elective surgery. METHODS: Patients were randomly allocated to two groups. The first group (group 1) received O2 treatment over the protective face mask. In the second group (group 2), the protective face mask was worn over the O2 delivery system. Heart rate, oxygen saturation (SPO2) level, end-tidal carbon dioxide (EtCO2) level, and respiratory rate were measured using a patient monitor at 0, 5, 10, 15, 30, and 45 minutes and recorded. The primary outcome of the study was the determination of the EtCO2 levels, which were used to assess the safety of the mask in terms of potential carbon dioxide retention. FINDINGS: None of the participants' SPO2 levels fell below 92% while wearing masks. There was no statistically significant difference between the groups in terms of EtCO2, heart rate, SPO2, and respiratory rate (P > .05). CONCLUSIONS: During the COVID-19 pandemic, protective surgical face masks can be used safely in the postoperative period for pediatric patients aged 3 to 10 years.

Leaching Performance and Zinc Ions Removal from Industrial Slag Leachate Using Natural and Biochar Walnut Shell.

This study aims to investigate leaching characteristics of zinc slag according to leaching tests, including; TCLP (Toxicity Characteristic Leaching Procedure), SPLP (Synthetic Precipitation Leaching Procedure), ASTM-D3987 (American Society for Testing and Materials), and TS EN-12457-4 (Turkish Standards Institute) tests methods. The present study describes the adsorption potential of natural and biochar walnut shells for removing ions from the zinc leachate. TCLP leachate, with a value of 38.575 mg/L, has a high zinc (Zn+2) concentration compared to other methods. Therefore, TCLP leachate was used in the adsorption experiments. Adsorption experiments were carried out at different adsorbent dosages, pH values, and contact time conditions. In the dosage study, the highest removal efficiency was obtained as 84% and 92% in natural and biochar walnut shell adsorbents, respectively. As a result of pH study, it was observed that adsorption under alkaline conditions had a much higher removal efficiency. Moreover, adsorption studies performed against contact time were applied to four different kinetic models and both adsorbents were found to be fit with the pseudo-second-order model. This kinetic model showed that the Zn+2 adsorption mechanism of natural and biochar walnut shells is chemical adsorption. With this study, it was shown that a very high 96% zinc removal can be achieved under optimum adsorption conditions. This may be the first study of zinc removal after leaching from industrial slag in the literature. This study has shown that high removal efficiencies can be obtained by an economical adsorbent.

Evaluation of effectiveness of pathology reports in active surveillance of tuberculosis.

OBJECTIVE: Despite advancing technology, national TB surveillance systems are still inadequate in terms of patient detection around the world. It was aimed to investigate suspicious cases detected by active surveillance method in pathology laboratories and to evaluate the effectiveness of this method in terms of finding new TB cases. METHODS: This is a descriptive cross-sectional study. It was administrated in Samsun, Turkey, between January 2012-December 2017. Within the scope of active surveillance, pathology laboratories were regularly visited and reported cases with granulomatous inflammation were assessed. The obtained patient list was compared with the records of the Electronic Tuberculosis Management System (ETMS). Patients who were not included in these records were invited to the dispensary and evaluated for TB. They were also referred to the relevant hospitals for diagnosis if necessary. Frequency values and descriptive statistics were calculated using SPSS method. RESULTS: It was found that 35.6% of 703 patients with the diagnosis of granulomatous inflammation were previously diagnosed, treated or currently undergoing treatment in the ETMS registry. As a result of the assessment of remaining 453 cases, 46 patients (10.1%) were newly diagnosed with TB. Newly diagnosed TB patients were reported, and their treatment started. CONCLUSION: As a result, active surveillance method conducted in pathology laboratories are used to detect unknown or late reported TB cases and allows to start treatment without further delay.

Prevalence of overweight and obesity among school children and parents: a cross-sectional study.

INTRODUCTION: Obesity, a complex and multifactorial disease causing severe health problems, is still the second most important cause of preventable deaths after smoking. Another risk is that childhood obesity is associated with overweight and obesity in adulthood. This study provides information on the prevalence of overweight and obesity in primary school students and their parents on location (rural v urban) and gender. METHODS: In this population-based, cross-sectional study, the anthropometric and demographic data of 9786 children and 6855 parents were analyzed. The study was conducted between 1 October 2016 and 30 November 2016 on a sample representing all public and private primary school students aged 6-10 years in Samsun province, Turkey. The multi-stage stratified sampling method was used in selecting the research sample according to the number of district students, the number of public/private primary school students, and the number of rural/urban students. In the BMI values classification, cut-off points in the age- and gender-specific growth charts of the Centers for Disease Control and Prevention were used for students, and the International Obesity Task Force cut-offs were used for parents or guardians. After the data acquisition was completed, a questionnaire form developed by the researchers was sent to the parents through the students. While children's anthropometric measurements were performed in their classrooms, parents or guardians self-reported their weight and height. Statistical Package for the social Sciences v22.0 was used for statistical analysis of the data. RESULTS: The study group consisted of 5005 (51.1%) boys and 4781 (48.9%) girls. The 6855 parents comprised 5258 (76.7%) mothers and 1597 (23.3%) fathers. The mean age was 8.2±1.2 years in children and 36.2±6.7 years in parents. Obesity prevalence was 10.5% in children and 20.2% in their parents. Childhood obesity was more prevalent in boys and in those living in urban areas (12.0% and 12.3%, respectively) than in girls and in those living in rural areas (9.0% and 4.5%, respectively). Conversely, adulthood obesity was more frequent in females and in those living in rural areas (20.4% and 21.8%, respectively) than in males and in those living in urban areas (19.7% and 20.4%, respectively). CONCLUSION: BMI values were higher among those of male gender and those living in rural areas. Combating obesity requires further multidisciplinary research to reveal the reasons for the differences based on place and gender, especially on nutrition and healthy lifestyle behaviors.

Evaluation of the Opinions of Family Physicians on Some Tobacco Products.

This study aimed to evaluate the opinions of family physicians, who have an important place in preventive health services, on some tobacco products. The sample of the descriptive study was composed of family physicians working in 408 family health centers serving Samsun, Turkey. The data were obtained by distributing a questionnaire prepared by the researchers to volunteer family physicians during in-service trainings organized by the Samsun Provincial Directorate of Health in February and March 2019. In all, 322 (79%) family physicians who participated in the trainings were included in the study. The average age of the participating physicians was 45.0 ± 7.6 years; 61.5% of them were male. More than one third (36.0%) of family physicians said that they had never smoked, while 23.6% of them were current smokers. Most (85.0%) said that they knew what an electronic cigarette was, 94.7% of them were familiar with hookahs, and 9.0% knew about I Quit Ordinary Smoking (IQOS). It is important to inform all healthcare professionals, and especially family physicians, about those products marketed by the tobacco industry as "less harmful" than cigarettes. It is thought that providing appropriate counseling services to these professionals will contribute to the fight against tobacco use.

Effects of submucosal PRP injection on wound healing in endonasal surgeries: an experimental study.

PURPOSE: To investigate the effects of submucosal platelet-rich plasma (PRP) injection on nasal mucosal wound healing after endoscopic sinus surgery. METHODS: 24 New Zealand white rabbits were randomly divided into three groups. To mimic surgery, injury was created using 3-mm punch forceps on ventral turbinate mucosa for all groups. Submucosal PRP was injected to the damaged mucosa in the first group (PRP group, n = 8), where 0.9% saline solution to the second group (saline group, n = 8) and no injection to the third one (control group, n = 8). All the animals were sacrificed 14 days after surgery; histopathological examination and hydroxyproline measurements were performed on the mucosa of all groups. RESULTS: Neutrophils, goblet cells, and collagen intensity were found significantly lower (p < 0.05) in PRP group than the control group. Also, the number of ciliary and goblet cells, and collagen intensity were found significantly lower (p < 0.05) in PRP group, than the saline group. In PRP group, hydroxyproline levels were found (p < 0.05) significantly lower than the saline and the control group, and no significant difference was found between the saline group and the control group (p > 0.05). CONCLUSION: There are many studies in literature showing the positive effects of PRP on wound healing. The results of this study also demonstrated positive effects of PRP on the nasal mucosa. According to these results, PRP injection to the injured nasal mucosa showed anti-inflammatory, mucus-softening, and synechia-reducing effects. Therefore, submucosal PRP injection after endonasal surgeries can be considered an effective application for maintaining nasal physiology.

Evaluation of Depression and Anxiety Levels and Related Factors Among Operating Theater Workers During the Novel Coronavirus (COVID-19) Pandemic.

PURPOSE: Tremendous physical and psychological pressure has been placed on health care workers because of the outbreak of novel coronavirus disease 2019. This study aimed to examine the anxiety and depression levels and related factors among health care professionals working in operating theaters (anesthetic technicians and nurses) during the coronavirus disease 2019 pandemic. DESIGN: The universe of this descriptive study consisted of health care professionals working in operating theaters in various health care institutions in Turkey. METHODS: Data were collected online between April 9, 2020 and April 12, 2020 using a SurveyMonkey Questionnaire (SurveyMonkey, San Mateo, CA) and health care workers who volunteered to participate in the study were contacted via the social media platforms Twitter, LinkedIn, and WhatsApp and asked to answer the questionnaire. Statistical analysis was performed using the SPSS version 22.0 software. FINDINGS: A total of 702 health care professionals working in operating theaters participated in the study. The mean depression and anxiety scores of the participants were found to be 9.4 ± 4.6 (min 0 to max 21) and 10.0 ± 4.5 (min 0 to max 21), respectively. Depression scores were statistically significantly higher among females, single individuals, those who had children, those living with a person aged 60 years or older (P < .05). Meanwhile, anxiety scores were statistically significantly higher among females, single individuals (including widowed and divorced), university graduates, those with at least one chronic disease, and those whose workload increased (P < .05). CONCLUSIONS: The present study showed that anxiety and depression symptoms were high among health care professionals working in operating theaters. To reduce these symptoms, psychological conditions of health care professionals can be followed continuously and regularly via standard procedures, and necessary interventions can be provided in the early period.

The Role of Lactate and Troponin-I Levels in Predicting Length of Hospital Stay in Patients with Carbon Monoxide Poisoning.

BACKGROUND: Carbon monoxide (CO) is one of the most common causes of unintentional poisonings resulting in death. Patients with more severe findings such as loss of consciousness and persistent neurological or cardiovascular dysfunction require hospitalization. Although there are clinical findings which determine hospitalization criteria in patients presenting with CO poisoning, there is some ambiguity regarding laboratory biomarkers which determine length of hospital stay (LOS) in these patients. In this study, we aimed to identify the effectiveness of initial blood gases and biochemical parameters in predicting LOS in patients presenting to the emergency department with CO poisoning by retrospective analysis of medical records. METHODS: This study was conducted in the Emergency Department (ED) of Samsun Training and Research Hospital by analyzing from medical records retrospectively of 275 patients who were admitted to the hospital following acute CO poisoning between January 2014 and July 2017. The patients were divided into 3 groups according to LOS: Group I, patients with LOS < 24 hours; group II, those with LOS > 24 hours and < 3 days; and group III, those with LOS > 3 days. RESULTS: In comparisons regarding lactate and troponin-I, it was found that there were significant differences in both parameters among the three groups (p = 0.000) and that both lactate and troponin-I levels were higher in group III than groups I and II, with group I being lowest (group III > group II > group I). While there was a mod¬erate positive statistically significant correlation between LOS and lactate (r: 0.43, p = 0.001) and troponin (r: 0.31, p = 0.001), a weak positive correlation was determined with CK (r: 0.19, p = 0.04). In this study, it was found that lactate and troponin-I values were more effective in predicting LOS when compared to carboxyhemoglobin levels and other biochemical parameters. CONCLUSIONS: The results of this study may guide clinicians to predict LOS in patients who present with CO poi-soning and have high troponin-I and lactate levels at the time of admission to EDs.

Predicting tularemia with clinical, laboratory and demographical findings in the ED.

INTRODUCTION: We aimed to determine clinical, laboratory and demographical characteristics of tularemia on admission to Emergency Department (ED). MATERIAL AND METHODS: Medical data of 317 patients admitted to ED and subsequently hospitalized with suspected tularemia between January 1, 2011, and May 31, 2015, were collected. Patients were divided into 2 groups according to microagglutination test results, as tularemia (+) and tularemia (-). RESULTS: Of the 317 patients involved, 49 were found to be tularemia (+) and 268 were tularemia (-). Mean age of the tularemia (+) patients was found to be higher than that of tularemia (-) patients. When compared to tularemia (-) patients, a significant portion of patients in tularemia (+) patients were elderly, living in rural areas and had contact with rodents. When clinical and laboratory findings of the 2 groups were compared, any statistical significance could not be determined. CONCLUSION: Tularemia is a disease of elderly people living in rural areas. Contact with rodents also increases risk of tularemia in suspected patients.

Bronchiectasis After Solid-Organ Transplant: A Retrospective Single Center Study.

OBJECTIVES: Bronchiectasis is characterized by abnormal, persistent, and irreversible enlargement of the bronchi. Many etiological factors have been described, but there are limited data on the development of bronchiectasis after organ transplantation. Our study is the first to study evaluate the frequency of bronchiectasis in heart and liver transplants as well as kidney transplants. Our aim is to analyze the frequency of bronchiectasis development after solid-organ transplant and the characteristics of the cases and to evaluate potential relationships. MATERIALS AND METHODS: We retrospectively analyzed data of patients who underwent solid-organ transplant at the Baskent University Faculty of Medicine Hospital through the hospital electronic information system. Demographic, clinical, and laboratory data and thoracic computed tomography scans were evaluated. RESULTS: The study included 468 patients (151 females/317 males). Kidney transplant was performed in 61.5% (n = 207), heart transplant in 20.3% (n = 95), and liver transplant in 18.2% (n = 85) of patients. Development of bronchiectasis was detected in only 13 patients (2.7%). We determined a 13.64-fold risk of developing bronchiectasis in patients with chronic obstructive pulmonary disease and 10.08-fold risk in patients with pneumonia by multivariate regression analyzes, in which all possible risk factors for the development of bronchiectasis after transplant were evaluated. CONCLUSIONS: The pathophysiology of transplantassociated bronchiectasis has not yet been clarified. Underlying diseases, recurrent pulmonary infections, and potential effects from immunosuppressive drugs may contribute to the pathogenesis of bronchiectasis. Further prospective studies are needed to include long-term health outcomes in transplant patients with and without bronchiectasis.

The problem of unaccompanied children in the earthquake; insufficient enrollment.

Türkiye experienced two of the most catastrophic earthquakes of the last century on February 6, 2023. The first earthquake with a magnitude of 7.7 occurred at 4.17 a.m. in Kahramanmaras City. Nine hours later, the second earthquake with a magnitude of 7.6 hit a region, which has 10 cities and over 16 million people. After the earthquakes, the Director-General of the World Health Organization, Hans Kluge, announced that a level 3 emergency was declared.One of the problems that should be solved at the earliest period in earthquakes is the problem of orphans or unaccompanied children. These children, referred to as 'earthquake orphans', can be potential victims of violence, organized crime, organ trafficking, drug addiction, sexual exploitation, or human trafficking. The already low socioeconomic level of the region, the magnitude of the earthquake, and the turmoil in the emergency rescue organization cause concern about the fact that the number of fragile children's population that will be affected will be higher than expected. The problem of orphaned children experienced in previous major destructive earthquakes provides important experiences for earthquake preparation.

Oncology mortality: weekend and summer vacation effect.

OBJECTIVES: In this study, we investigated the effect of the weekend and summer vacation on mortality in patients with cancer. METHODS: All patient data were obtained from their hospital registry records and the Death Notification System of the Ministry of Health. RESULTS: The majority of patients died in the hospital compared at home, 80.8% versus 19.2%, respectively. Patients aged <65 died mostly in hospital, which was the opposite of those aged ≥65, who died at home. While tumour location and histopathological type had no effect on the place of death, patients with metastasis (including single organ metastasis), diffuse metastases (diffuse metastases: multiple organ metastases) and patients with locally advanced stage disease were found to die more frequently in the hospital. Deaths in the hospital occurred most frequently in August, while deaths at home occurred most frequently in April and October. Deaths in the hospital occurred most frequently on Friday, Saturday and Sunday, while deaths at home occurred more frequently on Monday. It was determined that the deaths in the hospital were significantly higher at the weekend. CONCLUSION: This study contains data supporting the weekend effect in oncology patients. Moreover, it provides new data on the increased death rates in August, which coincides with the summer vacation leave month.

How close are children with obesity to becoming an adult with chronic illnesses?

OBJECTIVES: Childhood obesity has become a global threat due to its serious negative consequences. We aimed to determine the patterns of metabolic syndrome and cardio-metabolic risk factors in Turkish children with obesity. METHODS: We examined 169 schoolchildren with obesity in April and May 2019 in Samsun, Turkey. After clinical evaluation and anthropometric measurements, fasting blood samples were collected to measure total cholesterol, low and high-density lipoprotein, fasting blood glucose, triglycerides, and insulin levels. RESULTS: The proportion of those who met the metabolic syndrome criteria in boys was 14.3%, but it was twice as high in girls (28.2%). The most prevalent component of cardio-metabolic risk factor was increased waist circumference (96.4%) followed by a high homeostasis model assessment insulin resistance index (74.6%) and high blood pressure (29.0%). While the average high-density lipoprotein was higher in boys than in girls, on the contrary, insulin, HbA1c, and homeostasis model assessment insulin resistance concentrations were higher in girls. The prevalence of dyslipidemia was also higher in girls (67.1%) than in boys (47.6%), as were all impaired metabolic syndrome components. CONCLUSIONS: One in five children with obesity was at risk of metabolic syndrome. For early intervention and prevention, children with obesity should be monitored in terms of cardio-metabolic risk factors, but obese girls are more prioritized.

Restrictive effects of thalassemia on respiratory functions: One center experience.

OBJECTIVE: Respiratory functions in thalassemia major (TM) patients concerning poor chelation are a frequently researched issue. Our study aims to evaluate the lung functions of our patients with TM in the chronic transfusion program and to correlate them with their age, ferritin levels, and pre-transfusion hemoglobin values. METHODS: Height, weight, pulmonary function test (PFT) results, pre-transfusion hemoglobin levels, and ferritin levels of 97 patients (55 boys and 42 girls) without any underlying cardiac or chronic respiratory disease were recorded. PFT is consisted of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), the ratio of FEV1/FVC to peak expiratory flow (PEF), and forced mid-exhaled flow between 25% and 75% of mid-expiratory flow (MEF25-75). Data were analyzed with IBM SPSS V25. RESULTS: Low FVC was observed in 58 patients (60%), and low FEV1 was observed in 26 patients (27.6%). Low PEF was observed in 62 patients (64.5%), and low MEF25-75 was observed in 8 (8.3%). PFT was affected in 75 patients (78.1%). The pattern of involvement was restrictive. Age, height, and ferritin values significantly affected the MEF25-75 (p<0.05). Age and pre-transfusion hemoglobin values had a significant effect on the FVC test (p<0.05). There was a weak negative correlation between ferritin values and MEF25-75 (r=-0.221) and a weak positive correlation between pre-transfusion hemoglobin and FVC (r=0.222). CONCLUSION: Age and height are the main risk factors affecting FEV1, MEF25-75, and PEF. Serum ferritin has only an effect on MEF25-75 in our study. The respiratory functions of TM patients were affected in a restrictive pattern.

The Psychological Effects of the COVID-19 on Students Who Choose the Medical Profession With Different Motivational Factors: A Cross-Sectional Study.

The COVID-19 pandemic has generated mental and psychological health problems worldwide. The aim of this study was to determine whether the psychological effects of COVID-19 were different in medical students who chose the medical profession with different motivational factors. In the study, there were 389 medical school students. The survey asks about sociodemographic features and the students' reasons for choosing the medical profession. The study also included a self-assessed Hospital Anxiety-Depression Scale and Beck Hopelessness Scale. While 41% of students chose the medical profession for economic reasons, the ratio of whom have an extrinsic and intrinsic source of motivation was 37% and 22%, respectively. It was found that there was a statistically significant difference in the distribution of motivational factors by gender. Almost 50% of males were affected by economic motivation factors. The difference in motivational factors between genders was found to be statistically significant. Anxiety in females, depression in students with low-income families, and hopelessness in students older than 22 years and interns were higher than in the others (P < .05). Median scores for anxiety, depression, and hopelessness were higher for students with extrinsic motivational sources. However, only the difference in scores of anxiety and hopelessness was found statistically significant (P < .05). We found that the psychological effects of the COVID-19 pandemic varied according to both sociodemographic characteristics of the medical students and reasons for choosing medical profession. According to our results, the idealistic students interested in the medical profession, who want to support others and prioritize economic benefits, had fewer psychological issues than those who chose the medical profession due to family pressure or external factors.