El uso excesivo de pantallas está asociado con labilidad emocional en niños preescolares / Excessive screen time is associated with emotional lability in preschool children

Introducción. En estudios anteriores, el uso excesivo o la exposición temprana a pantallas se asoció con atención deficiente, falta de control de la conducta, retraso del lenguaje y déficit en la función ejecutiva. El objetivo de este estudio fue investigar la relación entre el tiempo de uso de pantallas y la regulación emocional, que afecta las relaciones sociales de los niños de 2 a 5 años.Población y métodos. Estudio descriptivo transversal en un hospital universitario del 1.º de enero al 1.º de marzo de 2018. Se incluyó a madres de niños sanos de 2 a 5 años con un uso de pantallas inferior a 1 hora o superior a 4 horas. A quienes aceptaron participar se les administró una encuesta estructurada y la Emotion Regulation Checklist para padres.Resultados. De los 240 niños participantes, 98 (el 40,8 %) tenían un uso de pantallas ≥ 4 horas. Ser cuidado por la madre, tener 12 meses o más durante la primera exposición y no estar acompañado por los padres al usarlas se asociaron con ≥ 4 horas de uso de pantallas (p = 0,002; p = 0,002; p = 0,012, respectivamente). La proporción de participantes con una puntuación alta de labilidad/negatividad (L/N) fue significativamente mayor entre los niños con ≥ 4 horas de uso de pantallas y que no estaban acompañados por sus padres al usarlas (p = 0,004; p = 0,033, respectivamente).Conclusiones. Este estudio determinó que un uso excesivo de pantallas se asocia con labilidad emocional durante esta etapa temprana de la infancia.

Introduction. Previous studies have found that excessive screen time or early screen exposure is associated with poor attention, lack of behavioral control, delayed language and deficit in executive functions. The aim of this study was to investigate the relationship between screen time and emotion regulation skills, which is one of the important life components affecting the social relations of children aged 2 to 5 years.Population and methods.This cross-sectional descriptive study was carried out in a university hospital between January 1, 2018 and March 1, 2018. Mothers of healthy children aged 2-5 years with a daily screen time of less than 1 hour or over 4 hours were included in the study. A structured survey and the Emotion Regulation Checklist for parents were applied to the mothers who agreed to participate.Results. Of 240 children participating in the study, 98 (40.8 %) had ≥4 hours of screen time. Caring by mother, age at first screen exposure 12 months and older, not co-viewing with parents were found to be associated with ≥ 4 hours of screen time (p = 0.002, p = 0.002, p = 0.012, respectively). The ratio of participants with high-lability/negativity (L/N) score was significantly higher in children with screen time of ≥ 4 hours and not co-viewing with parents (p = 0.004, p = 0.033, respectively).Conclusions. This study investigating the relationship between the emotion regulation skill and screen time revealed that excessive screen time is associated with emotional lability in this early childhood period.

Impact of Surgery on Growth, Pulmonary Functions, and Acute Pulmonary Exacerbations in Children with Non-Cystic Fibrosis Bronchiectasis.

BACKGROUND: Treatment decisions for the management of bronchiectasis include medical treatment, such as antibiotics, chest physiotherapy, and surgical procedures. Here, we aimed to review the effect of lung resection on longitudinal growth, clinical course of patients depending on annual exacerbation rates, and pulmonary function tests (PFTs) and compare them with the results of only medically treated children with non-cystic fibrosis (non-CF) bronchiectasis. METHODS: The medical records of patients with non-CF bronchiectasis were retrospectively analyzed. Patients who underwent lobectomy/segmentectomy/pneumonectomy were categorized as "surgery group" (n = 29). Age- and gender-matched patients who were only medically treated were selected as "medical group" (n = 33). Annual data of patients were included till the end of postoperative second year in the surgery group and third year of medical treatment in the medical group. RESULTS: Mean baseline height z-score was lower in the surgery group, and mean baseline PFT values were all lower in the surgery group than those in the medical group (p < 0.05). In the surgery group, mean values of height z-score were -1.68 ± 0.92 at the time of surgery and improved to -1.42 ± 1.22 and -1.34 ± 1.05 in the first and second postoperative years, respectively, and annual intravenous antibiotic requirements decreased significantly (p < 0.05); however, mean body mass index (BMI) z-score values and PFT parameters did not change significantly. In the medical group, height z-score mean values and PFT parameters showed nonsignificant improvement but annual exacerbation frequency, annual intravenous, and oral antibiotic requirements decreased significantly. CONCLUSION: Surgical management of non-CF bronchiectasis has no significant effect on BMI z-scores, annual exacerbation frequencies, oral antibiotic requirements and lung function tests; but can lead to significant improvement on height z-scores and decrease need of annual intravenous antibiotic requirements for acute severe exacerbations despite small number of patients in this study.

Maternal risk factors associated with lead, mercury and cadmium levels in umbilical cord blood, breast milk and newborn hair.

OBJECTIVE: Lead (Pb), mercury (Hg) and cadmium (Cd) are environmental pollutants that are wide spread throughout the world. The present study aimed to investigate the level of exposure to Pb, Hg and Cd during the prenatal period, and the possible routes of maternal exposure to these toxic heavy metals. PARTICIPANTS: The study included 123 mothers and their newborns. Umbilical cord blood samples were collected immediately after delivery, and breast milk and newborn hair samples were collected between postpartum d 3 and 10. RESULTS: Among the 121 cord blood samples that were analyzed, Pb was present in 120 (99.2%) and the mean level was 1.66 ± 1.60 µg dL(-1) (range:

Increased availability of family donors for hematopoietic stem cell transplantation in a population with increased incidence of consanguinity.

The study was planned to determine the frequency of parental and non-sibling family donor transplants in our center and to investigate the rate of familial donor availability at two HLA-typing laboratories in Turkey. Among 203 patients who underwent hematopoietic stem cell transplantation (HSCT), 151 (74.4%) received stem cells from siblings, 48 (23.6%) from non-sibling family donors, two (1.0%) from unrelated cord blood, and two (1.0%) autologous transplantation. Of these 48 patients received stem cells from non-sibling family donors; donors were mothers for 26 (12.8%), fathers for 20 (9.9%), and aunts for two (1.0%). The rate of transplants from parental donors was 22.6% in this patient population with increased frequency of inherited diseases (58.1%). Among these 203 patients, there was consanguinity between parents in 60.6% of the patients. Of 833 subjects applying as donor candidates to HLA-typing laboratories, 527 (63.3%) had HLA 6/6 identical family donors. Among 527 full-matched donors, 479 (90.9%) were sibling, 21 (4.0%) were fathers, and 17 (3.2%) were mothers. The remaining 10 (1.9%) were other relatives. The results have shown that the unfavorable factor of consanguinity marriage may increase the availability of family donors for HSCT in particularly developing countries where large donor registries are lacking.

The effect of glutamine supplementation on hematopoietic stem cell transplant outcome in children: a case-control study.

HSCT associated morbidity and mortality is usually attributed to high-dose chemotherapy/radiotherapy regimens used for conditioning. Glutamine (Gln), a conditionally essential amino acid during severe catabolic states, has been shown to have favorable effects in patients with malignancies and in those undergoing HSCT. However, controversy exists regarding its routine use. Studies in children investigating gln supplementation are very limited. In the present study, including 21 gln-supplemented and 20 control pediatric patients, gln supplementation was shown to reduce the duration of fever and decrease the incidence of SOS during the HSCT course. In addition, a decrease in drug-related toxicity and a trend toward reduced incidence of severe mucositis were observed.

Effect of aluminum adjuvants on safety and immunogenicity of Haemophilus influenzae type b-CRM197 conjugate vaccine.

OBJECTIVE: The present study was carried out to evaluate the safety and immunogenicity of the Haemophilus influenzae type b-CRM197 (Hib-CRM197) conjugate vaccine in relation to the change of adjuvant from aluminum hydroxide to aluminum phosphate (AlPO4). METHODS: The present study was a clinical phase II, observer-blind, randomized, multicenter, controlled study. Subjects were healthy infants aged 6-12 weeks, eligible for expanded program of immunization (EPI) routine vaccination and admitted to Hacettepe University Department of Social Pediatrics and Gülveren Health Center, Ankara. A total of 520 healthy infants were randomized in a 2:2:1 ratio to receive at either Chiron Hib/AlPO4 vaccine or VaxemHib (aluminum hydroxide adjuvant) vaccine or HibTiter (no adjuvant). Vaccines were administered simultaneously with routine diphtheria, tetanus and pertussis (DTaP) and oral polio vaccine (OPV) vaccines at 2, 4 and 6 months of age. Blood samples for anti-plain polysaccharide (PRP) antibody measurement were collected before the first vaccination and 1 month after the last vaccination. After each vaccination parents filled out a diary for 7 days. RESULTS: Out of 520 subjects enrolled, 514 received three doses and were included for safety analysis. Local and systemic reactions occurred with low and similar frequencies in all groups. Only erythema was more common in Chiron Hib/AlPO4 vaccine (19, 10, 11% in Chiron Hib/AlPO4, VaxemHib and HibTiter, respectively, P < 0.05). Nine serious adverse events were reported in seven cases of which none were related to vaccines. A total of 504 subjects were included in the immunogenicity analysis. The three vaccines were highly immunogenic and equivalent in terms of percentage of acquisition of long-term protective levels. The anti-PRP geometric mean titers were 9.9, 8.3 and 5.14 micro g/mL, respectively (P < 0.05). CONCLUSIONS: The use of aluminum compounds adjuvants in Hib-CRM197 conjugate vaccines does not impact the safety profile, while it does increase the magnitude of anti-PRP antibody titers.