Evaluation of epicardial adipose tissue in children with type 1 diabetes.

INTRODUCTION: Epicardial adipose tissue (EAT), the visceral fat surrounding the heart between the myocardium and visceral pericardium, intersects with Type 1 diabetes (T1D). This review aims to elucidate the intricate association between EAT and childhood T1D. MATERIALS AND METHODS: In this retrospective study, two pediatric groups were involved children with type 1 diabetes, and healthy children. Epicardial fat thickness was measured appropriately, and the study documented HbA1c levels and time to diabetes diagnosis for comprehensive analysis. RESULTS: Encompassing 51 children with T1D and 69 healthy controls, revealed that children with type 1 diabetes had a mean HbA1c level of 9.4 ± 0.2, and a mean insulin dose of 0.94 units/kg/day. Epicardial adipose tissue (EAT) values were significantly higher in the Type 1 DM group. It has been shown that epicardial fat thickness may have a specific and sensitive value in type 1 diabetics. DISCUSSION: The increased presence of epicardial fat tissue in children with type 1 diabetes is highlighted, prompting the consideration of various mechanisms. However, the complexity of this relationship underscores the need for further studies to provide a more comprehensive understanding of the underlying factors. Ongoing research in this area is crucial for advancing our knowledge and potential therapeutic interventions. IMPACTS: Cardiac complications are one of the most important causes of morbidity and mortality in people with type 1 diabetes. Being able to detect cardiological complications of diabetes at an early stage contributes to morbidity. We found that epicardial fat tissue thickness was thicker in children with type 1 diabetes than in healthy children. Epicardial fat tissue thickness may be associated with poor control in children with type 1 diabetes and maybe a guide in terms of cardiac risks.

Diaphragm thickness by ultrasound in pediatric patients with primary malnutrition.

Skeletal muscle atrophy is known to be a marker for nutritional deficiency. The diaphragm is both a skeletal muscle and a respiratory muscle. There is not enough data in the literature about the change in diaphragm thickness (DT) in children with malnutrition. We think that malnutrition may have negative effects on diaphragm thickness. Therefore, in this study, we aimed to compare the diaphragm thicknesses of pediatric patients with primary malnutrition and a healthy control group. The DT of pediatric patients diagnosed with primary malnutrition by a pediatric gastroenterologist was prospectively evaluated by a radiology specialist by ultrasonography (USG). The obtained data were statistically compared with the data of the healthy control group. There was no statistically significant difference between the groups in terms of age and gender (p = 0.244, p = 0.494). We found that right and left diaphragm thicknesses were significantly thinner in the malnourished group than in the healthy control group (p = 0.001, p = 0.009, respectively). We found that right and left diaphragm thicknesses were thinner in those with moderate and severe malnutrition compared to the normal group (p < 0.001, p = 0.003, respectively). We found a significant weak positive correlation between weight and height Z score and right and left diaphragm thickness (respectively, r: 0.297, p < 0.001; r: 0.301, p < 0.001).   Conclusion: Malnutrition is a disease that affects all systems. Our study shows that the DT is thinner in patients with malnutrition. What is Known: •Malnutrition causes skeletal muscle atrophy. What is New: •Diaphragm muscle thickness decreases in malnutrition. •There is a significant positive correlation between diaphragm muscle thickness and height, weight and BMI z scores.

The interaction between seminal plasma biochemical constituents and short-term semen preservation in Honamli and hair goats.

This study investigated the short-term storage of Honamli and Hair buck semen based on the relationships among the biochemical constituents of the seminal plasma. In total, 12 Honamli and Hair goat bucks (six of each breed) were used. Collected individual semen samples were divided into two parts, one placed in short-term storage and the other centrifuged to determine the biochemical constituents of the seminal plasma. Diluted semen samples were cooled to +4°C; the samples were stored at this temperature; the spermatological parameters (i.e., motility, plasma membrane and acrosome integrity [PMAI], viability and high mitochondrial membrane potential) were assessed at 0, 24, 48, 72 and 144 h. A significant positive correlation was determined between the PMAI, motility and viability with globulin, chlorine, alanine aminotransferase (AST) and aspartate aminotransferase (ALT). A positive correlation was detected between the PMAI and viability with total protein. In contrast, a negative correlation was determined between the motility and viability with sodium values in buck semen (p Ë‚ .05). Also, it was evaluated the Hair buck samples became inviable across all parameters at 72 h, while the Honamli buck samples continued to be viable at 144 h. In conclusion, the seminal plasma biochemical parameters of total protein chlorine, globulin, albumin, sodium, AST and ALT correlated with spermatological parameters in buck semen. The factors of animal (p Ë‚ .05) and time (p Ë‚ .001) affected the spermatological parameters, but there was no interaction between the two factors (p > .05) during the short-term storage period. Also, it was determined that Honamli buck semen was more resistant to cold injury than Hair buck semen against cold injury during storage.

Investigation of the effects of syringic acid supplemented to Tris semen diluent on ram semen freezability.

To the best of our knowledge, no research has been conducted to test the effects of syringic acid (SA) on ram semen freezing within the scope of natural antioxidants added to semen extenders. Therefore, this study had two main objectives. First, to test whether adding SA to ram semen freezing extender has a protective effect and contributes positively to sperm kinetic, plasma and acrosome integrity, mitochondrial membrane potential, lipid peroxidation, oxidant and antioxidant and DNA damage parameters after thawing. Second, it was to determine at what concentration the SA supplemented to the extender could be applied by in vitro studies by preserving the fertilization ability of frozen semen at the highest level. In the study, six individuals of Sönmez rams were used. The semen was collected from the rams using an artificial vagina and pooled. The pooled semen was divided into five different groups and extended with 0, 0.5, 1, 2 and 4 mM SA (control C, SA0.5, SA1, SA2 and SA4, respectively). After dilution, the semen samples were kept at 4°C for 3 h, then loaded into 0.25 mL straws and frozen in liquid nitrogen vapour. The SA1 and SA2 groups were higher plasma membrane and acrosome integrity (PMAI), high mitochondrial membrane potential (HMMP), plasma membrane integrity and motility compared to other groups (p < .05). It was observed that SA supplemented to the Tris extender significantly reduced DNA damage, and the lowest values were obtained especially in the SA1 and SA2 treatments (p < .05). Also, lowest MDA level was determined at the SA1 and this was statistically significant compared to SA4 and C (p < .05). In conclusion, it was revealed that SA added to Tris semen extender at 1 and 2 mM treatment doses increased progressive and total motility and preserved PMAI, plasma membrane integrity, HMMP and DNA integrity.

Haematological parameters predicting cardiac involvement in children with COVID-19 infection.

AIM: Haematological parameters obtained from the full blood count, such as neutrophil-to-lymphocyte ratio (NLR), are cost-effective tests which have been shown to be predictive of the prognosis of many diseases. We aimed to evaluate certain haematological parameters and cardiac biomarkers to test whether they could predict cardiac involvement by COVID-19 infection. METHODS: This retrospective study included patients aged 1 month to 18 years having a positive COVID-19 PCR test but no comorbidity, who were admitted to the paediatric emergency department between 15 March 2020 and 1 February 2021. RESULTS: There were 292 COVID-19 PCR-positive patients, 12 MIS-C patients and 70 healthy controls. A receiver operator characteristic curve analysis was performed to predict MIS-C in patients with COVID-19 infection. An NLR value of ≥5.03 could predict MIS-C with a sensitivity of 66.7% and a specificity of 91.6%; a proBNP value of ≥329.5 ng/L with a sensitivity of 91.7% and a specificity of 95.6%; a CKMB value of ≥2.95 µg/L with a sensitivity of 100% and a specificity of 77.7%; and a troponin-I value of ≥0.03 µg/L with a sensitivity of 75% and a specificity of 99.2%. A logistic regression analysis showed that an NLR value of ≥5.03 increased the risk of MIS-C 19.3 fold; a proBNP value of ≥329.5 ng/L increased the risk 238 fold; and a troponin-I value of ≥0.03 µg/L increased the risk 60 fold. CONCLUSIONS: At the time of admission, parameters such as proBNP, troponin-I and NLR can predict the development of MIS-C in COVID-19 patients with high sensitivity and specificity.

Thymoquinone improves motility, plasma membrane integrity and DNA integrity of frozen-thawed ram semen.

The aim of this study was to determine the effects of thymoquinone (TQ), which is the most essential active compound of Nigella sativa, on the spermatological parameters of ram semen during cryopreservation. Ejaculates were collected from five Sonmez rams using an artificial vagina and extended with Tris-based extender not containing TQ (control, 0 µg/ml TQ) and containing 10, 25, 50 and 100 µg/ml TQ. The extended semen samples were equilibrated in a + 4°C cold cabinet for 2 h. After 2 h, the samples were loaded into 0.25 ml French straws. The straws were frozen by liquid nitrogen vapour and stored in a liquid nitrogen container (-196°C). The frozen straws were thawed in a water bath (37°C for 30 s) and evaluated in terms of motility characteristics, plasma membrane and acrosome integrity, mitochondrial reactive oxygen species levels, lipid peroxidation levels, DNA damage and biochemical alterations (oxidative stress index, malondialdehyde and glutathione). TQ100 had higher total motility (53.59 ± 3.01) and progressive motility (19.84 ± 1.44; not significantly different from TQ25 and TQ50) compared to the control and TQ10 (p Ë‚ 0.05). According to the results of the analyses on motility characteristics, there were significant differences between the groups in terms of curvilinear velocity (VCL), amplitude of lateral head displacement (ALH) and linearity (LIN; p Ë‚ 0.05). The highest DNA damage was detected in the control group (p Ë‚ 0.05). TQ50 had higher plasma membrane and acrosome integrity (59.56 ± 5.92) compared to the control and TQ25 (p < 0.05) but not significantly different from TQ10 and TQ100. The lowest mitochondrial reactive oxygen species levels were detected in TQ50 and TQ100 (p Ë‚ 0.05). There were no significant differences among the groups in terms of their oxidative stress index, lipid peroxidation, malondialdehyde and glutathione levels (p > 0.05). According to the results, it could be concluded that supplementing 50 or 100 µg/ml TQ to Tris extenders that were used for ram semen cryopreservation showed a positive effect on motility, plasma membrane integrity and acrosome integrity, and it reduced DNA damage and mitochondrial reactive oxygen species levels.

Effects of synthetic (JWH-018) cannabinoids treatment on spermatogenesis and sperm function.

JWH-018 is a synthetic cannabinoid which has been increasingly used by adolescents and adults, and is known to cause severe multi-organ failure. However, little is known about the complications and toxicological effects of JWH-018 on reproduction system. Therefore, the aim of the present study is to investigate the effects of JWH-018 on testis and spermatogenesis. Thirty CD-1 male rats were distributed into six groups, control group (C1 and C2), ethanol group (E1 and E2), and JWH-018 group (JWH1 and JWH2), which were administered 0.9% NaCl, %100 ethanol, and JWH-018 (0.3 mg/kg) respectively for 9 d. We euthanized C1, E1, and JWH1 group mice at day 2 and C2, E2, and JWH2 group mice at 45 d after the last injection to evaluate the acute testis damage and potential recovery of spermatogenesis. The histopathology of seminiferous epithelium was evaluated and organ weight, sperm concentration and motility, membrane integrity, and serum testosterone levels were statistically analyzed. In JWH1, seminiferous tubule degeneration, partial germ cell depletion disorganized seminiferous epitheliums were seen. We also observed significantly decreased sperm concentration, sperm motility, intact membrane, and testosterone levels in JWH1 group compared to other groups. Forty-five days after the JWH-018 treatment, sperm concentration, motility, and testosterone level were increased, suggesting that testis and spermatogenesis can recover. We concluded that the use of JWH-018 may adversely affect male reproductive potential and testis histopathology.

Could an Increased Percentage of Immature Granulocytes Accompanying Dyspepsia Predict COVID-19?

Background and Aim: Although vaccination practices continue at a fast pace around the world, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still threatens people's lives. In this study, we aimed to determine the presence of SARS-CoV-2 in patients who do not have the typical symptoms of the novel coronavirus disease 2019 (COVID-19), but only present with dyspepsia, and to investigate the role of immature granulocytes in the early diagnosis of these patients. Material and Methods: Adult and pediatric patients suffering from dyspepsia were included in the study. The patients were divided into two groups, ''positive'' and ''negative'', based on their SARS-CoV-2 polymerase chain reaction test results. Immature granulocyte count (IG), immature granulocyte percentage (IG%), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) values were recorded. Results: A total of 238 patients, including 25 (10.5%) pediatric and 213 (89.5%) adult patients, were included in the study. A total of 2 (8%) pediatric patients and 17 (7.9%) adult patients tested positive for SARS-CoV-2. The IG, IG%, and CRP parameters were significantly higher in the SARS-CoV-2-positive patients compared to the SARS-CoV-2-negative patients. The optimal cut-off value predictive of COVID-19 infection was determined to be ≥0.650 (sensitivity: 52.6% and specificity: 95.5%, p = 0.001) for IG%. Conclusions: It should be noted that dyspepsia may also be a COVID-19 symptom. IG% values, which can be determined with a hemogram test, a cheap and easily accessible test, may be a warning in the early detection of patients who do not have the typical symptoms of COVID-19.

Predictive value of cardiac markers in the prognosis of COVID-19 in children.

BACKGROUND AND AIM: Occasionally, children with COVID-19 may develop arrhythmia, myocarditis, and cardiogenic shock involving multisystemic inflammatory syndrome in children (MIS-C). This study aimed to identify the laboratory parameters that may predict early cardiovascular involvement in these patients. MATERIALS AND METHODS: Data of 320 pediatric patients, aged 0-18 years (average age, 10.46 ± 5.77 years; 156 female), with positive COVID-19 reverse transcription-polymerase chain reaction test and with cardiac biomarkers at the time of admission to the pediatric emergency department were retrospectively scanned. The age, sex, COVID-19-associated symptoms, pro-brain natriuretic peptide (proBNP), CK-MB, and troponin I levels of the patients were recorded. RESULTS: Fever was noted in 58.1% of the patients, cough in 29.7%, diarrhea in 7.8%, headache in 14.7%, sore throat in 17.8%, weakness in 17.8%, abdominal pain in 5%, loss of taste in 4.1%, loss of smell in 5.3%, nausea in 3.4%, vomiting in 3.8%, nasal discharge in 4.4%, muscle pain in 5%, and loss of appetite in 3.1%. The proBNP value ≥282 ng/L predicted the development of MIS-C with 100% sensitivity and 93% specificity [AUC: 0.985 (0.959-1), P < 0.001]; CK-MB value ≥2.95 with 80% sensitivity and 77.6% specificity [AUC: 0.792 (0.581-1), P = 0.026]; and troponin I value ≥0.03 with 60% sensitivity and 99.2% specificity [AUC: 0.794 (0.524-1)]. CONCLUSIONS: Cardiac markers (proBNP and troponin I), especially proBNP, could be used to detect early diagnosis of cardiac involvement and/or MIS-C in pediatric patients with COVID-19 and to predict related morbidity and mortality.

MIS-C with diarrhea complaint and acute kidney injury: A pediatric COVID-19 patient.

We present the case of a 3-month-old male infant patient who initially presented with severe dehydration with acute kidney injury secondary to COVID-19. Regarding the individual's previous history, the patient had congenital heart disease and was taking furosemide and captopril. The patient improved after initial hydration therapy. However, on the fourth day of hospitalization, the patient suddenly deteriorated and was found to have MIS-C. The patient's clinical course progressively worsened despite maximum support, and he died from severe MIS-C. We conclude that during the COVID-19 period, MIS-C is a serious health problem that should be considered in the differential diagnosis of patients with acute kidney injury.

Gallic acid improves the viability and mitochondrial membrane potential of post-thawed goat buck semen.

The aim of this study was to determine the effects of gallic acid (GA) on frozen-thawed goat spermatozoa. Four Honamli goat bucks were used at their breeding season, and ejaculates were collected by an electroejaculator. Mixed semen was divided into the following four groups: control (0 mM), low (L; 1 mM), medium (M; 2 mM), and high (H; 4 mM) concentration of GA. All the groups were frozen and thawed in a water bath for spermatological evaluation. The lowest motility was observed in the control group (47.60 ± 5.70%) (P < 0.05), while the highest viability (62.45 ± 1.68%), plasma membrane and acrosome integrity (44.81 ± 4.57%), and high mitochondrial membrane potential (35.96 ± 2.50%) were observed in the low GA group (P < 0.05). Also, the lowest hypo-osmotic swelling test (HOS +) value was found in the high GA group (47.60 ± 4.82%) (P < 0.05). In conclusion, supplementing a low concentration (1 mM) of GA to the Tris-based semen extender had a positive effect on spermatological parameters after freeze-thawing of Honamli goat semen. Further studies should be continued in other species with different doses and combinations using commercial and/or homemade semen extenders.

Is it possible to diagnose fulminant Wilson's disease with simple laboratory tests?

BACKGROUND: Wilson's disease is a rare cause of acute liver failure and is highly fatal without liver transplantation. Fast and accurate diagnostic methods are needed for fulminant Wilson's disease (FWD). In this study, we aimed to develop an early, simple and accurate diagnostic method to differentiate FWD from nonwilsonian acute liver failure (NWALF) causes using routine biochemical data. METHODS: The medical records of 24 paediatric FWD and 120 paediatric NWALF cases diagnosed at the Department of Pediatric Gastroenterology, Hepatology, and Nutrition between January 2007 and February 2017 were retrospectively reviewed. RESULTS: Using receiver operator characteristics curve (ROC) analysis, we have determined the best cut-off point for laboratory findings in FWD. Patients meeting these cut-off points were assigned one point and others were assigned zero point. We then formed a new variable consisting of the combination of 14 variables and performed a new ROC analysis. We obtained a cut-off point of ≥4.5 for FWD. The diagnostic performance of the score was characterized by a sensitivity of 0.889, a specificity of 0.879 (P < .001). A scoring system based only on aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, AST/ALT ratio, uric acid and haemoglobin had a best cut-off point of ≥2.5 for FWD, which had a sensitivity of 0.875, a specificity of 0.867 (P < .001). CONCLUSIONS: Our study demonstrated that biochemical markers offer almost as reliable, fast and accurate diagnosis of FWD as offered by ceruloplasmin and 24-hour urinary copper.

Red pine (Pinus brutia Ten) bark tree extract preserves sperm quality by reducing oxidative stress and preventing chromatin damage.

This study aimed to investigate the effectiveness of using red pine bark tree extract (P; Pinus brutia Ten) as a TRIS extender in an attempt to prevent oxidative stress in bull spermatozoa after freezing. Semen specimens were obtained from Simmental bulls via an artificial vagina and pooled. They were separated into five specimens and diluted with Tris extender consisting of P (200, 100, 50 and 25 µg/ml) and P free (control; C) up to a final concentration of 16 × 106 per straw. All specimens were equilibrated for a period of 4 hr at a temperature of 4°C, following which they were filled in 0.25-ml French straws and frozen. Addition of P resulted in favourable tail length in comparison with C (p < .05). The lowest malondialdehyde levels and the highest glutathione levels were detected in all P groups (p < .05). Supplementation with P did not show advanced results in terms of total, progressive sperm motility and total abnormality in comparison with C (p > .05). In conclusion, it has been shown that although P added to a Tris extender does not have a positive effect on sperm motility, it prevents chromatin damage by reducing oxidative stress, in addition to reducing head abnormalities when used at the amount of 50 µg/ml.

The comparison of the resistivity index values in the ultrasonographic evaluation of a unilateral atrophic/hypoplastic kidney.

Background: In the study, we aimed to determine the sensitivity of the renal resistivity index (RI) in differentiating hypoplastic and atrophic kidneys in patients with small-sized kidneys, and to evaluate its capacity to predict the renal involvement confirmed by the DMSA scintigraphy.Material and methods: We retrospectively reviewed the ultrasonography (US) and DMSA findings, and medical records of pediatric patients with unilateral diminutive kidneys followed between January 2017 and June 2018. The RI measurements were performed twice, and the mean RI was calculated for each kidney of all patients.Results: Sixty-three (male/female, m/f = 28/35) pediatric patients aged 107.2 ± 49.4 months (range 14-206 months) were included in this study. The DMSA scintigraphy revealed abnormal changes to atrophic kidneys in 38 patients and hypoplastic kidneys in 25. There were no differences between the groups with atrophy and hypoplasia by age, gender, urine density, and creatinine. The patient group with atrophic kidneys had a mean RI of 0.55 ± 0.21, and patients with hypoplastic kidneys had a mean RI of 0.67 ± 0.03. The mean RI and systolic/diastolic rates of the patients with atrophy were significantly lower than of the patients with hypoplastic kidneys (p = 0.042 and p = 0.048, respectively). There was a positive correlation between RI and DFR in the group with atrophy (r = 0.461, p = 0.016), but this was not the case for the group with hypoplastic kidneys (r= -0.066, p = 0.889).Conclusions: The resistivity index might be very useful for differentiating atrophy and hypoplasia in patients with unilateral small kidneys and can be used instead of scintigraphic evaluation.

Gallic and carnosic acids improve quality of frozen-thawed ram spermatozoa.

The objective was to determine effects of gallic acid (GA) and carnosic acid (CA), present in carob pods and rosemary extract respectively, on frozen-thawed ram spermatozoa. Thirty ejaculates were collected from five Merino rams, pooled, diluted in Tris-based extender and divided into five equal portions containing: 0.05 or 2 mM of GA; 0.05 or 0.2 mM of CA; or no additive (control). Extended semen was equilibrated at +4°C, loaded into straws, held 5 cm above liquid nitrogen for 12 min then plunged. Computer-aided sperm analysis was used to assess motility, whereas flow cytometry was used to assess high mitochondrial membrane potential (HMMP) and percentages of spermatozoa with plasma membrane and acrosome integrity (PMAI). Spermatozoa supplemented with 2 mM GA had greater total motility than control spermatozoa (39.9 ± 3.01 vs. 29.2 ± 1.31%, mean ± SEM, p < .05). The PMAI was greatest in 0.2 mM CA (13.3 ± 0.68%), whereas HMMP was highest in 0.05 mM CA but lowest in control (22.9 ± 4.95 and 11.4 ± 3.64% respectively; p < .05). In conclusion, for cryopreservation of ram semen in Tris-based extender, supplementation with 2 mM GA increased post-thaw motility, whereas supplementation with 0.05 mM CA enhanced mitochondrial function.

Effects of arginine and trehalose on post-thawed bovine sperm quality.

The present study was conducted to examine the protective role of arginine and trehalose on post-thaw bull sperm and oxidative stress parameters. Five ejaculates for each bull were used in the study. Each ejaculate, split into three equal aliquots and diluted at 37 °C with base extenders containing 2 mM arginine, 25 mM trehalose and no antioxidant (control) was cooled to 5 °C and then frozen. Frozen straws were thawed in a water bath for evaluation. Supplementation of the semen extender with arginine decreased the percentages of post-thawed subjective motility (29 ± 8.21%), CASA motility (12.2 ± 5.69%) and progressive motility (3.52 ± 2.13%), compared with the controls (43 ± 2.73%, 55.4 ± 6.78% and 33.48 ± 4.14%, respectively, P < 0.05). Supplementation of the semen extender with trehalose produced a higher mitochondrial activity and sperm viability (36.3 ± 3.99% and 44.1 ± 2.18%) compared with the control (13 ± 8.15 and 31.7 ± 3.94%, respectively, P < 0.05). It was established that trehalose (95.1%) and arginine (92.8%) protect DNA integrity compared to the control (90.4%) (P < 0.05). Trehalose supplementation in semen extenders provided great benefit in terms of viability, mitochondrial activity, and intact sperm DNA on frozen-thawed bull sperm.

Rare Cause of Hematochezia in Children: Solitary Rectal Ulcer, Single Center Experience.

Background/Aims: Solitary rectal ulcer syndrome (SRUS) can be overlooked, diagnosed late, or misdiagnosed, particularly in childhood. This study reviewed the 13-year experience of the authors' institution to increase clinicians' awareness of SRUS in the presence of symptoms. This paper reports the endoscopic and histopathological findings in children presenting with hematochezia. Methods: The clinical and laboratory findings of 22 patients diagnosed with biopsy-proven SRUS in the authors' clinic between 2007 and 2020 were evaluated retrospectively. Results: The mean age at diagnosis was 12.5±2.6 years, and 59.1% of the patients were male. The median time of diagnosis was 24 months. A single ulcer lesion was found by colonoscopy in 18 patients (81.8%), two ulcers in two patients (9%), and more than two ulcers in two patients (9%). The pathology reports of all biopsies taken from the lesions were consistent with a solitary rectal ulcer. In the first stage, the treatment was started with toilet training, a high-fiber diet, and laxatives. In 11 patients (50%) who did not respond to the initial treatment, a 5-ASA enema was added. A glucocorticoid enema was added to treatment in five patients (22%) whose complaints did not regress despite this treatment. Clinical remission was achieved in five of the patients (18.1%). The time to diagnosis was significantly shorter in those in remission than those not in remission (p=0.04). Conclusions: This study is the first large series on Turkish children. An increased awareness of SRUS in children will increase the rate of early diagnosis and treatment, allowing remission in more patients.

The Value of Electroencephalogram (EEG) Findings in the Evaluation and Treatment Management of Pediatric Acute Liver Failure.

Background Pediatric acute liver failure (PALF) is still life-threatening and requires urgent care. The presence of encephalopathy is a clinical diagnosis, but it is more difficult to diagnose in children than in adults, and an electroencephalogram (EEG) can be invaluable. The role of EEG in managing the treatment of patients with PALF, other than the identification of encephalopathy, is unknown. This study aimed to investigate patients' EEGs, which may guide in choosing the most appropriate treatment in encephalopathy children. A further aim was to investigate a new score method, based on the laboratory results, which might indicate the presence of encephalopathy in cases with PALF. Methods Medical data of 33 PALF patients followed in our clinic were reviewed retrospectively. This study included 33 patients, whose EEG recording was taken on the first day of supportive treatment due to liver failure in the pediatric intensive care unit (PICU). The EEG findings were categorized into three classes: normal, epileptic and non-epileptic paroxysmal, and background encephalopathic patterns including widespread slowing and voltage suppression. Result This retrospective study included 13 male and 20 female patients with a mean age at presentation of 4.82±4.81 months whose EEG was performed on the first day of supportive therapy for liver failure in the PICU. The EEG findings were categorized into three groups: normal, epileptic and non-epileptic paroxysms, and encephalopathic patterns including diffuse background slowing and voltage suppression. Comparing EEG findings and treatments, we found that the normal EEG group responded well to liver-supporting therapy and the rate of plasmapheresis treatment was significantly higher in the diffuse slowing group. Patients with diffuse slowing of the EEG were 9.6 times more likely to receive plasmapheresis. We found that above a cut-off of ≥7.5 for the TAI (total bilirubin, albumin, and international normalized ratio (INR)) score used in our study, the risk of developing encephalopathy increased 14.4-fold. Conclusions In PALF, EEG findings can provide findings that will help clinicians in determining treatment selection and prognosis, as well as detecting epileptic focus and encephalopathy. The TAI score can be used to assess the risk of encephalopathy in cases of PALF, when it is challenging to identify encephalopathy or when an EEG is not possible.

Cryopreservation of ram semen: baicalein efficiency on oxidative stress, chromatin integrity, viability and motility post thaw.

Baicalein (B) has potential antioxidant properties, but it has not been tested as a ram semen extender. This study aimed to assess the impact of B on various sperm parameters and determine its potential influence on semen quality after the freeze-thawing process. During the breeding season, ejaculates were obtained from four rams with the aid of an artificial vagina. The collected mixed semen samples were divided into four groups: control (C; 0), B0.5 (0.5 mM), B1 (1 mM), and B2 (2 mM). After semen extension, the samples were loaded into 0.25 mL straws and stored for 2 h at 4°C prior to freezing in liquid nitrogen vapor and thawed in a water bath at 37°C. Among the groups, B0.5 demonstrated the highest progressive motility results, while B1 and B2 exhibited reduced motility (p < 0.05). In terms of high mitochondrial membrane potential, plasma membrane and acrosome integrity, and viability, B0.5 showed significantly superior outcomes to the other B groups (p < 0.05), although it was not significantly better than C. B1 displayed the highest plasma membrane integrity levels (p < 0.05). Notably, B2 displayed the lowest total antioxidant status levels among the groups (p < 0.05). The findings of this study suggested that the in vitro spermatological characteristics of ram spermatozoa such as progressive motility and chromatin integrity can be protected from the freeze-thawing process by using the 0.5 mM dose of baicalein as a semen extender. The treatment of sperm freezing might benefit from further in-depth research on the role of B in the improvement of cryoinjury and its underlying processes.

Cardiac anomalies in pediatric patients with pectus excavatum.

OBJECTIVE: Pectus excavatum is the most prevalently encountered deformity of the thoracic wall. It can be accompanied by congenital anomalies. METHODS: The cardiac findings of 36 children who were diagnosed at the Thoracic surgery outpatient clinic of our university between 10 February 2021 and 1 October 2021 and 57 healthy children in a similar age group were analyzed. RESULTS: We determined that the pectus excavatum patients in our study had a higher risk of having mitral insufficiency, mitral valve prolapse, tricuspid valve prolapse, cardiac malposition, and congenital heart disease. CONCLUSION: Our study showed that the prevalence of cardiac pathologies was higher in pediatric pectus excavatum patients than in healthy children in the control group. Thus, we recommend clinicians to refer pediatric pectus excavatum patients to pediatric cardiology outpatient clinics for the early diagnosis of potential cardiac pathologies.