The relation between increased carotid intima-media thickness with fibrin monomers in obese children.

AIM: This study aimed to investigate the association between carotid intima-media changes that play a part in the atherosclerotic process in childhood obesity and fibrin monomers as an important indicator of fibrin plaque. METHODS: This is a cross-sectional study of obese children and non-obese healthy control subjects. Height, weight, body mass index, waist/hip ratio, systolic/diastolic blood pressures were recorded, in addition, biochemistry, haemogram, fibrin monomers and d-dimer were measured in both groups. Right and left common carotid intima-media thicknesses were measured by ultrasonography and mean carotid intima-media thickness was calculated. RESULTS: Obese children (n = 89, 46.1% girls, median age: 12.6 ± 2.3 years) and healthy control group (n = 40, 52.5% girls, median age: 13.2 ± 2.2 years) were comparable in terms of gender, age and puberty stage. Mean carotid intima-media thickness was higher in obese children than the healthy control group (P = .002). There was no difference between the two groups in terms of fibrin monomers and d-dimer levels. In obese children, there was a weak negative correlation between mean carotid intima-media thickness and fibrin monomers (P = .030, r = -0.233). CONCLUSION: In obese children, mean carotid intima-media thickness was determined higher, as an early indicator of atherosclerosis. We want to emphasise that obese children are at risk for cardiovascular disease and should be evaluated in terms of atherosclerosis. This study investigates the relation between increased carotid intima-media thickness and fibrin monomers, in children, the first time in Literature.

The Effectiveness of Family Psychological Training Program Applied to Relatives of Patients with Schizophrenia.

BACKGROUND: The aim of the study is to improve the family relations of the patients who suffer for schizophrenia, to ensure the participation of the family in the treatment, to improve treatment compliance and to reduce relapse. SUBJECTS AND METHODS: A total of 80 caregivers of the patients, consisting of 40 people as a study group and 40 as a control group, the training was given in two sessions of forty five minutes twice a week, 24 sessions completed in approximately three months. It was applied in both groups at the beginning and end of the training the scales that are the test batteries. RESULTS: While there was no difference between the two groups according to the pre-test scores obtained before the family psychological training program, according to the post-test scores, there was a significant difference between two groups in terms of symptoms of depression and anxiety, solutionoriented coping, emotion-oriented coping, dangerous perception of the disease and emotion expression. CONCLUSION: The training programme thought that the family psychological training support to be given to the relatives of patients with schizophrenia will both contribute positively to the treatment and play an effective role in the adaptation of the caregivers' to the disease.

Re-emergence of genotype G9 during a five-and-a-half-year period in Turkish children with rotavirus diarrhea.

This study was done to understand the dynamics of rotavirus genotype distribution in Turkish children. Samples were collected from January 2006 through August 2011 from children at a hospital in Ankara. Rotavirus was detected in 28 % (241/889) of the samples. Genotype G9P[8] was predominant (28 %), followed by G1P[8] (16.3 %) and G2P[8] (15.9 %). G9 was absent in the samples from 2006 and 2007 and then re-emerged in 2008 and increased gradually. Phylogenetic analysis showed that Turkish G9 rotaviruses of the present study formed a sublineage with strains from Italy and Ethiopia, possibly indicating spread of a clone in these countries.

[Investigation of norovirus infection incidence among 0-5 years old children with acute gastroenteritis admitted to two different hospitals in ankara, Turkey]. / Akut Gastroenterit Nedeniyle Ankara'da Iki Farkli Hastaneye Basvuran 0-5 Yas Arasi Çocuklarda Norovirus Enfeksiyonu Sikliginin Arastirilmasi

Norovirus causes severe gastroenteritis requiring hospitalization especially in children less than five years of age both in developed and developing countries. Therefore, we aimed to investigate the incidence of norovirus (NoV) in 0-5 years old children with acute gastroenteritis in two large hospitals in Ankara, Turkey. Stool samples were obtained from 1000 (413 female, 587 male) children between 0-5 years old with acute gastroenteritis who attended to the Department of Paediatrics, Ministry of Health Ankara Training and Education Hospital and affiliated hospital of Gazi University Faculty of Medicine between October 2004 and June 2011. Antigens of norovirus GI and GII genogroups in the stool specimens were detected by ELISA (RIDASCREEN® Norovirus (C1401) 3rd Generation, R-Biopharm, Germany). Norovirus GI and GII antigens were determined in a total of 141 (14.1%) samples, of them 62 (15%) were female and 79 (13.5%) were male, yielding no statistically significant difference (p> 0.05). The highest NoV positivity was detected in children between 12-23 months (17.1%), however there was no statistically significant difference between ELISA positivity and age (p> 0.05). NoV detection rate was highest in 2007 (18.4%) and in 2009 (18%), and the difference regarding ELISA positivity among the study years was not statistically significant (p> 0.05). The prevalences of norovirus infection in spring, summer, autumn and winter were 13.8%, 17.7%, 14.7% and 11.2%, respectively. Therefore no seasonal variation was found in the incidence of norovirus infection. However when the monthly prevalence was analyzed, a statistically significant difference was found (p< 0.05) between the rate of norovirus infection in july (24.2%) and december (4.1%). When evaluating the clinical symptoms, all of 141 patients (100%) had diarrhoea, while 72 (51.1%) had vomiting. Stool samples were also evaluated for the presence of parasitic and bacterial agents. Coinfection rate with parasites was detected as 3.3% (4/122; norovirus + Entamoeba histolytica in three cases, norovirus + Enterobius vermicularis in one case), while no pathogenic bacteria were isolated from norovirus positive stool samples. The prevalence rate of 14.1% for NoV GI/GII infection detected in this retrospective study including 0-5 years old children in Ankara for 2004-2011 period was thought to reflect the regional data and would contribute to national epidemiological data. We anticipate that the incidence of norovirus will increase in 0-5 year old children as a result of increasing use of rotavirus vaccine in Turkish children. It was concluded that, NoV antigen detection tests should be used in routine laboratories for appropriate diagnosis of sporadic and/or epidemic norovirus infections.

Association between perceived social support, marital satisfaction, differentiation of self and perinatal depression.

OBJECTIVE: The aim of the study was to investigate the relationship between peripartum depression and social support, marital satisfaction, and self-differentiation. METHODS: This cross-sectional study was conducted on postpartum women from December 28, 2021, and March 31, 2022. Postpartum women were evaluated using a questionnaire consisting of sections assessing sociodemographic characteristics, obstetric history, and psychometric instruments: Edinburgh Postpartum Depression Scale (EPDS), Marital Disaffection Scale (MDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Differentiation of Self Inventory (DSI). RESULTS: A total of 425 mothers were included in the study. Of those, 140 (32.9%) mothers scored ≥13 points on EPDS, and 285 (67.1%) mothers scored ≤12 points. Mothers who scored ≥13 on the EPDS were found to have significantly higher scores for marital dissatisfaction. Total scores of family support, friend support, emotional cutoff, fusion with others, and differentiation of self were higher in mothers who scored ≤12 points on the EPDS. There was no significant difference between the two groups in terms of significance with others, emotional reactivity and I position. CONCLUSION: This study found that marital satisfaction is important in the development of perinatal depression both directly and through family support and emotional cuttoff. In addition, mothers with family support, friend support, and self-differentiation had comparatively lower EPDS scores, while mothers with marital dissatisfaction had higher EPDS scores.

Infantile malignant osteopetrosis: a rare cause of neonatal hypocalcemia.

Infantile malignant osteopetrosis (IMO; OMIM 259700) is a rare inherited bone disease characterized by reduced or dysregulated activity of osteoclasts, resulting in generalized osteosclerosis. The disease usually presents within the first few months of life with anemia, hepatosplenomegaly, frontal bossing, nystagmus, blindness, deafness, and bone fractures. Children with IMO are at risk of developing hypocalcemia, with attendant tetanic seizures. We report the case of a baby boy who presented with neonatal hypocalcemia. Skeletal radiographs demonstrated sclerotic bones and a dense base of the skull with typical "space alien" face confirming the diagnosis of IMO. Pancytopenia developed at 2 months of age. Visual evoked potential showed severe bilateral optic nerve damage. Genetic mutation study revealed a new mutation in exon 13 of the TCIRG1 gene. Neonatal hypocalcemia can occur as result of IMO, which is easily missed out by clinicians. This causes delay in establishing the diagnosis and starting necessary treatment. Therefore, osteopetrosis should be kept in mind as a rare cause of neonatal hypocalcemia.

Increased coagulation in childhood obesity.

OBJECTIVE: This study aims to explore the relation between childhood obesity and procoagulant and anticoagulant systems. METHOD: Fifty-one obese children and 32 normal-weighted children with similar age and gender distribution and between ages of 5 and 16 years were recruited to the study. Antropometric measures of all subjects, existence of any accompanying disease, and medication histories had been recorded. Full blood count, procoagulant, and anticoagulant coagulation tests were run for all subjects. RESULTS: When hematologic variables of obese children were compared with those of healthy controls, it was found that average erythrocyte hemoglobin concentration, erythrocyte distribution width, and platelet count of obese children are significantly higher than healthy control group. It was also found that fibrinogen, thrombin time, factor (F) VIII, FIX, FX, and von Willebrand factor levels of obese children are higher than healthy control group. By contrast, antithrombin levels of obese children are found to be lower. CONCLUSION: In our study, we found that there is a procoagulant increase in the coagulation system activity of obese children compared to non-obese healthy children, whereas there is a significant decrease in anticoagulant system. These changes occurred in obese patients, especially higher levels of plasma procoagulant factors such as fibrinogen, FVIII, FIX, and von Willebrand factor, lead us to think that there is an activity in these patients at endothelial level. Further studies are needed on endothelial activity of obese children.

The mediating role of alexithymia and cognitive flexibility in the relationship between behavioral inhibition system/behavioral activation system and depression in Turkish population.

This study aims to examine the relationships between the behavioral inhibition system (BIS)/behavioral activation system (BAS), depression, cognitive flexibility, and alexithymia, and to determine the mediator role of cognitive flexibility and alexithymia in the relationship between BIS/BAS and depression. Data were collected from a community sample, consisting of 1,275 people, 904 women (70.90%) and 371 (29.10%) men, aged 18-65 years. It was detected that the whole variables in this research were interrelated. Additionally, for the mediation analyses, two significant models in which were determined the mediator role of cognitive flexibility and alexithymia in the relationship between the dimensions of BIS-Fear and BAS-Reward and depression were created. Consequently, high BIS-Fear and low BAS-Reward were associated with susceptibility to depression through decreased cognitive flexibility and increased alexithymia. Moreover, it may be possible to identify which subdimensions of alexithymia and cognitive flexibility play a role in the relationship between depression and reward/punishment systems and which of these are risk factors via the models tested in this study. In this way, clinical interventions for the factors that are both associated with depressive symptoms and mediators for depression can be planned and this can help to achieve effective results in the therapy process.

Bone measurements of infants with hyperbilirubinemia by quantitative ultrasound: the influence of phototherapy.

OBJECTIVE: The purpose of the current study was to investigate the possible effects of phototherapy on bone status of term infants evaluated by measurement of tibial bone speed of sound (SOS). MATERIALS AND METHODS: The phototherapy group (n = 30) consisted of children who had undergone phototherapy for at least 24 h and the control group (n = 30) comprised children who had not received phototherapy. Blood samples were obtained from all infants for serum calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone and vitamin D concentrations. The left tibial quantitative ultrasound (QUS) measurements were performed using a commercial device. RESULTS: There was no statistically significant difference between phototherapy-exposed and nonexposed infants in terms of Ca, P, ALP, PTH and vitamin D levels. Comparison of bone SOS between the phototherapy-exposed and control group revealed no statistically difference. Also, no significant difference in Z-score for SOS was observed between those with or without exposure. CONCLUSION: The data of our study indicate that phototherapy treatment has no impact on bone status in the hyperbilirubinemic infants. Although there is no statistically significant evidence of an excess risk of bone damage following phototherapy, studies with larger sample sizes and longer duration of follow-up are needed to gain a better understanding of its effects.

Ocular findings on follow-up in children who received phototherapy for neonatal jaundice.

BACKGROUND: To evaluate the ocular findings in children between 3 and 5 years of age who had received phototherapy in the neonatal period and to investigate whether they had phototherapy-related permanent ocular damage clinically. METHODS: The phototherapy group (n = 57) consisted of children who had undergone phototherapy for at least 24 h, and the control group (n = 43) comprised children who had not received phototherapy. Ophthalmic examinations consisted of assessment of visual acuity, convergence near point, ocular movements, ocular alignment, dynamic retinoscopy, cycloplegic refraction and biomicroscopic examination of anterior segment and posterior segment (using a 90 D lens in the latest). RESULTS: All children were orthophoric and had normal eye movements. A significant difference was found between the phototherapy group and control group regarding convergence near point 3.0 (2.0-5.0) vs 3.0 (2.0-5.0) (p = 0.018), right cycloplegic spherical equivalent 1.0 (0.0-3.0) vs 0.75 (0.0-4.75) (p = 0.011) and left cycloplegic spherical equivalent 1.0 (0.075-3.0) vs 0.75 (0.0-5.25) (p = 0.006).The study groups were similar according to cycloplegic spherical and cylindrical refractions. However, no significant difference was found between the groups regarding the need for eye glasses. CONCLUSION: Although there were significant differences between the phototherapy and the control groups according to the convergence near point and right and the left eye cycloplegic spherical equivalent, the similarity between the groups regarding the need for eyeglasses suggested that difference was clinically insignificant.

Evaluation of bone metabolism in newborn twins using quantitative ultrasound and biochemical parameters.

Metabolic bone disease (MBD) is one of the important complications of prematurity. Early and adequate nutritional interventions may reduce the incidence and potential complications of MBD. The present study aimed to evaluate bone metabolism in twins via biochemical parameters and quantitative ultrasound (QUS) and to compare the results between twin pairs. Moreover, twin infants were evaluated in terms of potential risk factors likely to have impact on MBD. Forty-three pairs of twins were included in the study. Serum calcium, phosphorus, magnesium, and alkaline phosphatase concentrations were assessed and bone mineral density was measured using QUS (speed of sound, SOS) at postnatal 30 d. Co-twin with the higher birth weight was assigned to Group 1 (n = 36) and the other twin was assigned to Group 2 (n = 36). Birth weight and head circumference were significantly higher in the infants of Group 1 compared with Group 2. No significant difference was found among the groups in terms of gender, history of resuscitation, length of stay in intensive care unit (ICU) or in the incubator, duration of total parenteral nutrition (TPN), type of nutrition, vitamin D use, biochemical parameters, and the SOS value. The factors likely to affect SOS, including type of pregnancy, maternal drug use, gender of infant, birth weight, head circumference at birth, gestational week, length of stay at the ICU, duration of TPN, type of nutrition, resuscitation, vitamin D use, and levels of calcium, phosphorus, magnesium, and alkaline phosphatase were entered into the model. The phosphorus level and the maternal drug use were found to be the factors that significantly reduced SOS, whereas pregnancy after assisted reproductive techniques was found to be a significant enhancing factor.

Evaluation of neurological and cardiological findings in carbonmonoxide poisoning in children.

AIM: The aim of our study was to investigate the relation of blood carboxyhemoglobin level with presentation finding and clinical properties and to demonstrate neurological and cardiological findings which are indicators of tissue hypoxia in patients followed up because of carbonmonoxide (CO) poisoning. MATERIAL AND METHODS: Three hundred and twenty-five patients who were followed up because of carbonmonoxide poisoning between 2011 and 2013 in our pediatric emergency department were evaluated prospectively. Ethics committee approval was obtained for the study on 10.19.2011 (number: 0437). The carbonmonoxide levels, source of intoxication, neurological and cardiological findings and treatment methods were recorded. Blood gases and cardiac enzymes were studied and electrocardiography (ECG) was performed. The data were analysed using SPSS for windows 16.0 package program. RESULTS: One hundred and sixty-eight (51.7%) of the patients were female and the median age was 9 years (11 days-17 years). Two hundred and twenty-eight (70.2%) of the patients were poisoned while using heater and 78.1% presented during winter months. The median carbonmonoxide level of the patients was found to be 24.8%. Cardiac enzymes were found to be increased in 10.5% of the patients, first degree A-V block was found in 0.6% and negative T wave was found in 0.3%. Glasgow coma score was found to be below 14 in 4.6% of the patients. A significant correlation was found between the carboxyhemoglobin levels and neurological findings, cardiological findings and lactate (p<0.05). Normobaric oxygen treatment was given to 76.3% of the patients and hyperbaric oxygen treatment was given to 23.7%. CONCLUSIONS: We think that neurological disorders and cardiac findings may be closely related, since systemic involvement may be easier in carbonmonoxide poisoning in children, Glasgow coma score should be assessed in the follow-up of the patients and cardiac enzymes and serum lactate levels should be monitored closely from the time of presentation.

Necrotizing enterocolitis in a newborn following intravenous immunoglobulin treatment for haemolytic disease.

ABO iso-immunization is the most frequent haemolytic disease of the newborn. Treatment depends on the total serum bilirubin level, which may increase very rapidly in the first 48 hours of life in cases of haemolytic disease of the newborn. Phototherapy and, in severe cases, exchange transfusion are used to prevent hyperbilirubinaemic encephalopathy. Intravenous immunoglobulins (IVIG) are used to reduce exchange transfusion. Herein, we present a female newborn who was admitted to the NICU because of ABO immune haemolytic disease. After two courses of 1 g/kg of IVIG infusion, she developed necrotizing enterocolitis (NEC). Administration of IVIG to newborns with significant hyperbilirubinaemia due to ABO haemolytic disease should be cautiously administered and followed for complications.