Use of Different Iron Preparations for Prophylaxis and Effects on Iron Status in Infancy.

Aim: To evaluate using different iron preparations for iron deficiency and/or iron deficiency anemia prophylaxis in infants and their iron status. Methods: In this study, we retrospectively evaluated the electronic patient records of 651 healthy children aged 9 to 13 months who met the inclusion criteria and who were followed up in pediatric follow-up outpatient clinics between January 2023 and June 2023. Results: A total of 651 children with a mean age of 11.2 ± 1.4 months, 54.7% of whom were boys, who met the inclusion criteria were included in the study; 56.5% of the children were using Fe + 3 salt and the others were using Fe + 2 salt, microencapsulated iron, or sucrosomial iron drops. After the fifth month of prophylaxis, when the effects of the iron preparations used on the mean laboratory values were evaluated, it was found that hemoglobin, serum iron, and ferritin levels were lower in sucrosomial iron and microencapsulated iron users compared to other preparations (p = 0.001). When statistically pairwise comparisons were made between the groups, hemoglobin and serum iron values were found to be lower in the group using sucrosomial iron compared to the groups using Fe + 2 and Fe + 3 salts (p < 0.0001). Hemoglobin and ferritin levels were higher in the group using Fe + 2 salt compared to both sucrosomial iron and microencapsulated iron groups (p < 0.0001). When the infants were evaluated according to iron status, it was found that 208 (31.9%) had iron deficiency. Iron deficiency was found to be less in infants of families who defined their economic status as rich and in infants who used iron regularly (p-values 0.044 and 0.001, respectively). Iron deficiency/iron deficiency anemia was observed at a higher rate in the group using sucrosomial iron and microencapsulated iron prophylaxis (p = 0.001). Conclusions: To prevent iron deficiency, it is very important to use appropriate iron preparations for prophylaxis and to feed foods with high iron content. Although we found that families were willing to use different iron preparations other than iron salts for their infants, the results presented herein indicate that the rate of iron deficiency was lower in patients using iron salts. However, randomized controlled studies are needed to determine whether these preparations are effective in iron prophylaxis in infants.

Episodic apnea: gastroesophageal reflux associated with gastric organo-axial malrotation: a case report.

BACKGROUND: Gastroesophageal reflux is a normal physiologic process occurring several times a day in healthy infants. On the other hand, symptoms such as failure to thrive, feeding or sleeping problems, chronic respiratory distress, persistent forceful vomiting, and choking may indicate reflux associated with underlying anatomic, neurological, or infectious abnormalities. Gastric malrotation is an extremely rare disorder in the pediatric population and one of the anatomic causes associated with severe reflux, which could lead to serious complications. In such cases, life-threatening symptoms overlapping with other diseases cause delayed diagnosis and treatment. CASE PRESENTATION: We report a 2.5-month-old white girl diagnosed with gastric malrotation-related reflux, which caused inadequate weight gain, feeding difficulties, episodes of apnea with cyanosis, and choking after successive coughing, hence previously misdiagnosed as epilepsy and pertussis. CONCLUSION: Life-threatening symptoms in an infant with reflux suggest anatomic, neurological, or infectious conditions. Gastric malrotation is more common than generally thought and specifically looked for in young children with severe reflux symptoms, and should be diagnosed and treated as soon as possible.

Effectiveness of Pelargonium sidoides in pediatric patients diagnosed with uncomplicated upper respiratory tract infection: a single-blind, randomized, placebo-controlled study.

Upper respiratory tract infections (URTIs) are a condition characterized by upper airway inflammation often caused by viruses in humans. The present study aimed to assess the effectiveness of the liquid herbal drug preparation from the root extracts of Pelargonium sidoides in improving symptoms of uncomplicated URTIs. One hundred sixty-four patients with URTI were randomized and given either verum containing the root extracts of Pelargonium sidoides (n = 82) or a matching placebo (n = 82) in a single-blind manner for 7 days. The median total scores of all symptoms (TSS) showed a significant decreasing trend in the group treated with the root extracts derived from Pelargonium sidoides compared to the placebo group from day 0 to day 7 (TSS significantly decreased by 0.85 points in the root extract group compared to a decrease of 0.62 points, p = 0.018). "Cough frequency" showed a significant improvement from day 0 to day 3 (p = 0.023). There was also detected a significant recovery in "sneezing" on day 3 via Brunner-Langer model, and it was detected that the extract administration given in the first 24 h onset of the symptoms had provided a significant improvement in day 0 to day 3 (difference of TSS 0.18 point, p = 0.011).Conclusion: The findings of the study revealed that the Pelargonium sidoides extracts are effective in relieving the symptom burden in the duration of the disease. It may be regarded as an alternative option for the management of URTIs. What is Known: • Upper respiratory tract infections (URTIs), an inflammation on the upper airways, are the most common infectious disease in children. • Pelargonium sidoides, a traditional medicinal plant native to South Africa, is one of the ornamental geraniums that is thought to be effective in treating URTIs What is New: • It may be revealed that the dried root extract of Pelargonium sidoides compared with placebo might be an alternative treatment in improving the symptoms such as dry cough, sneezing, and relieving cough frequency. • The administration of the root extract at the onset of URTIs' signs may be regarded as an adjunctive option for the management of URTIs due to its effectiveness in decreasing the symptom burden of the disease.

Persistent wheezing along with apparent stridor caused by a rare anomaly: double aortic arch.

Vascular rings are rare anomalies that occur as a result of abnormal development of the aortic arch complex, often manifested by signs of tracheo-oesophageal compression during the infant period. A double aortic arch anomaly is the most common type of vascular ring pathology. Here we report a case presenting with wheezing and stridor in a 10-month-old child.

Normocomplementemic Urticarial Vasculitis Associated with A/H1N1 in a Child. Case Report.

Urticarial vasculitis is an entity characterized by urticarial rashes that are typically pruritic and painful, associated with angioedema and purpura. Influenza viruses are common respiratory pathogens that can cause seasonal infections and global human morbidity/mortality. A 4.5-year-old girl presented with fever and painful urticarial skin lesions leaving post-inflammatory hyperpigmentation. The nasal specimens showed a positive for influenza A/H1N1. On the basis of these findings, a diagnosis of urticarial vasculitis associated with A/H1N1 was concluded. Taking the results together, we suggest that urticarial vasculitic lesions can be considered to the list of cutaneous manifestations during the seasonal flu.

Primary ovarian rhabdomyosarcoma coexisting with Pseudo-Meigs' syndrome in a young patient: a case report and brief literature review.

Primary rhabdomyosarcoma is one of the malignant soft tissue sarcomas of childhood originating from embryonic mesenchyme. The tumor can occur in the head, neck region, and limbs, and genitourinary system. Primary ovarian rhabdomyosarcoma is an extremely rare malignancy with a few documented pediatric patients in the literature. Pseudo-Meigs' syndrome is a type of Meigs' syndrome that is usually associated with other benign ovarian tumors or any other type of malignant tumors. It is a rare condition characterized by ascites, pleural effusion, benign ovarian tumors or fibroma-like tumors, and resolution of ascites and pleural effusion after the removal of the tumor. A patient of Asian origin came to our clinic with symptoms of mild dyspnea, and gradually increasing abdominal swelling. Magnetic resonance imaging scans indicated masses with solid cystic components on both ovaries with a suspicion of malignancy, showing bilateral pleural effusion and massive ascites. This is the first reported case of a pure primary ovarian rhabdomyosarcoma associated with a Pseudo-Meigs syndrome in a young girl.

Diagnostic Accuracy of the Mean Platelet Volume in the Prediction of Upper Urinary Tract Infections.

BACKGROUND: The studies have reported that mean platelet volume may be a marker in the discrimination of upper and lower urinary tract infections. We investigated whether the mean platelet volume was a reliable indicator in upper and lower urinary tract infections. METHODS: One hundred and eighty-two patients between the ages of 1 month and 14 years who were diagnosed with urinary tract infection were included in this study. The mean platelet volume values, clinical and other laboratory characteristics of the groups were compared. The discriminative ability of each biomarker for patients with UUTI was evaluated by drawing receiver operating characteristic (ROC) curves for the biomarkers. All values of p < 0.05 were considered statistically significant. RESULTS: The leukocyte count, C-reactive protein, and erythrocyte sedimentation rates of the patients with upper urinary tract infection were significantly higher than the patients with lower urinary tract infections (p < 0.001). However, there was no statistically significant difference in terms of the mean platelet volume values between patients with upper and lower urinary tract infection ([7.2 (1.3) vs. 7.2 (1.6) fL]; p = 0.79, respectively). The value of the area under the curve of MPV's p-value was > 0.05. However, p-values of CRP and ESR were significant in ROC analysis. CONCLUSIONS: Our study showed that there was no significant difference in the mean platelet volume values between patients with upper and lower urinary tract infections. The use of mean platelet volume as an indicator of upper urinary tract infection is controversial.

Predictive role of laboratory markers and clinical features for recurrent Henoch-Schönlein Purpura in childhood: A study from Turkey.

Objectives: Henoch Schönlein Purpura is the most common systemic vasculitis of the childhood. The objective of this study was to evaluate whether there is a clinical significance of laboratory parameters and clinical features on the prediction of the recurrent Henoch Schönlein Purpura in children.Methods: For recurrent Henoch Schönlein Purpura, several laboratory results and clinical features were examined to identify the predictor factors via the logistic regression model in 99 children with Henoch Schönlein Purpura. A p-value of <.05 was considered significant. The patients were divided into two groups as the first attack and the recurrent.Results: The demographic features and laboratory results were not found statistically significant between the two groups (p > .05). The multiple logistic regression model showed that the risk of recurrent Henoch Schönlein Purpura increased 17.2-fold in children with Henoch Schönlein Purpura affected by the four systems including skin, joint, kidney and gastrointestinal system [Odds Ratio (OR) 17.2, 95% CI 1.4-12; p < .001].Conclusion: In our inpatient population, the laboratory characteristics were detected not to be a factor for the prediction of recurrence. However, the four systems including skin, joint, kidney and gastrointestinal involvement may be used as a predictive factor for recurrent HSP.

A case of May-Thurner Syndrome: An old anomaly but, a new suggestion: A case report.

May-Thurner syndrome (MTS) is an anatomical condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine. MTS is rarely diagnosed because diagnostic workup is seldom continued once the diagnosis of a deep vein thrombosis (DVT) has been established. Furthermore, patients with DVT generally have several well-known confounding risk factors. We report a 16-year-old girl with a history of left leg swelling who was incidentally diagnosed with MTS. We hope that our case report will create awareness of vascular abnormalities in sports medicine and suggest that routine venous Doppler ultrasound screening may help to detect MTS or associated anatomical prior to the formation of early thrombosis.

Duane retraction syndrome in a patient with abnormal head position.

Duane's syndrome is a rare retraction anomaly characterized by an innervation defect in the lateral rectus muscle, limitation of abduction and adduction due to the result of abnormal innervation of the horizontal rectus muscles, changes in the eyelid fissures, and abnormal vertical eye movements. The affected eye is displaced up and/or down in adduction. This syndrome, also known as Stilling-Turk-Duane syndrome, accounts for approximately 1 to 5% of all strabismus cases. In this article, we present a one-and-a-half-year-old male patient who had abnormal head position, and was diagnosed as having Duane retraction syndrome. Through this study, we want to draw attention to Duane retraction syndrome, which is one of the rare causes of strabismus.

Parotitis coexisting with Kawasaki disease in a child: a rare presentation of Kawasaki disease.

Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome and infantile polyarteritis nodosa, is known to present in multiple ways. Although inflammatory changes in several systems have been reported in KD, there are few documented child patients presenting with parotitis. We report such a case in a five-year-old.

Outbreak of varicella in preschool children despite one-dose vaccination.

Kurugöl Z, Gökçe S. Outbreak of varicella in preschool children despite one-dose vaccination. Turk J Pediatr 2018; 60: 56-62. In Turkey, a single-dose varicella vaccine was introduced into the National Immunization Program in 2013. Before this implementation, varicella vaccine had been available in the private sector since 2000. However, varicella outbreaks continued to occur in preschools and elementary schools. We investigated a varicella outbreak to estimate the effectiveness of 1-dose varicella vaccine and to evaluate potential risk factors for breakthrough disease. This study was carried out during a varicella outbreak in 3 preschools in Izmir, Turkey, in April 2016. Using questionnaires, data including children`s medical and vaccination histories were collected from their parents. Attack rates in vaccinated and unvaccinated children were calculated and the analyses of vaccine effectiveness and of risk factors for breakthrough disease were conducted. A total of 124 children were enrolled in the study. Of the 124 children, 77 (62%) had received 1-dose varicella vaccine before the outbreak. Varicella developed in 34 of 124 children during the outbreak, and 18 of them (53%) had breakthrough varicella. The attack rate was 23.4% among vaccinated children and 34% among unvaccinated children. The effectiveness of single-dose varicella vaccine was 33.6% against varicella disease of any severity and 82.5% against moderate or severe varicella. Children vaccinated 5 or more years before the outbreak had 3.5 times the risk of disease than those who had been vaccinated more recently (OR 3.5 [95% CI, 1.08-11.5]); p= 0.046). Age at vaccination ( < 15 months vs.≥15 months) and the brands of varicella vaccine were not associated with the increased risk of breakthrough varicella. Our study suggests that one-dose of varicella vaccine is not sufficient to prevent school outbreaks. A 2-dose varicella vaccination program may help to prevent varicella outbreaks and achieve effective control of the disease.

The role of mean platelet volume in the early detection of acute bronchiolitis: A prospective study.

INTRODUCTION AND OBJECTIVE: Acute bronchiolitis might be associated with morbidity and mortality in infants. The aim of this study was to evaluate the role of mean platelet volume (MPV) in the prediction of acute bronchiolitis. METHOD: One hundred and eighty-four of these infants were diagnosed with acute bronchiolitis and 100 were healthy children. The ability of MPV, C-reactive protein (CRP), white blood cell (WBC) count, and lymphocyte values to predict all bronchiolitis groups and the control group was examined by receiver operating characteristic (ROC) curve and their respective areas under the curves (AUC) with 95% confidence intervals. RESULTS: Patients with acute bronchiolitis had higher MPVs than their healthy counterparts (P < 0.001). However, there was no difference statistically significant in MPVs among all bronchiolitis groups (P = 0.239). ROC curve analysis suggested that MPV level cut-off point for making the prediction of acute bronchiolitis was 6.0 fL, with a sensitivity and specificity of 90% and 28%, respectively. Our results clearly indicated that AUCs for the MPV, CRP, WBC, and lymphocyte were statistically significant for bronchiolitis groups versus the control group. However, AUC values for MPV were the lowest. CONCLUSIONS: These findings suggest that the MPV might be a predictive value for the diagnosis of acute bronchiolitis. However, the predictive capacity of the CRP is better than that of others. Observational studies with a larger group to evaluate the clinical significance of MPV are necessary to predict acute bronchiolitis.

Corrigendum to "A Rare Cause of Childhood Cerebellitis-Influenza Infection: A Case Report and Systematic Review of Literature".

[This corrects the article DOI: 10.1155/2017/4039358.].

Chlamydia trachomatis infection influences the clinical course of acute bronchiolitis.

The frequency of Chlamydia trachomatis infection among young infants admitted with acute bronchiolitis was analysed to determine whether the former affects the clinical course of the latter. A total of 92 infants aged <6 months admitted with acute bronchiolitis were tested for C. trachomatis by a cell culture technique, obtaining nasal smears from each infant's nostrils. A second nasal sampling was taken for respiratory viruses from the study group and tested with real-time polymerase chain reaction. Clinical characteristics of C. trachomatis-positive and -negative cases were compared. C. trachomatis was detected in 22.8% of the infants, mostly as coinfection with respiratory viral agents. Infection with C. trachomatis affected the clinical outcome in acute bronchiolitis and such infants tended to have severe bronchiolitis.

Bordetella Pertussis Infection in Hospitalized Infants with Acute Bronchiolitis.

OBJECTIVE: To assess the frequency of B. pertussis infection among young infants hospitalized with acute bronchiolitis and to determine whether B. pertussis infection affects the clinical course of acute bronchiolitis. METHODS: A total of 172 infants <6 months of age hospitalized with acute bronchiolitis were tested for B. pertussis and respiratory viruses with real-time PCR. Cases were divided into 2 groups according to B. pertussis positive or negative. Clinical parameters, clinical severity scores and laboratory characteristics of the pertussis-positive and pertussis-negative cases were compared. RESULTS: Bordetella pertussis infection was detected in 44 (25.6%) of the 172 infants hospitalized for acute bronchiolitis, and as co-infection with respiratory viral agents in 27 (61.4%) infants. Of the 44 pertussis-positive infants, only 17 (38.6%) experienced a paroxysmal cough, 13 (29.5%) had whooping and 15 (34.1%) had post-tussive vomiting. There was no significant difference between pertussis-positive and pertussis-negative infants according to Wang clinical score at admission (4.9 ± 1.5 vs. 5.2 ± 2.5; p = 0.689). The overall disease severity score was also similar between the two groups (6.5 ± 1.4 vs. 6.9 ± 1.6; p = 0.095). CONCLUSIONS: Bordetella pertussis infection is common in young infants hospitalized for acute bronchiolitis, mostly as co-infection with respiratory viruses. The clinical features of pertussis in the infants are not characteristic. Viral bronchiolitis and pertussis cases could not be differentiated by clinical findings. Co-infection with pertussis did not affect the clinical outcome in infants hospitalized with acute bronchiolitis.

Etiology, Seasonality, and Clinical Features of Viral Respiratory Tract Infections in Children Hospitalized With Acute Bronchiolitis: A Single-Center Study.

The purpose of this study was to evaluate the viral frequency, seasonality, and clinical and demographic features of patients hospitalized with acute bronchiolitis. A cross-sectional, descriptive study was performed in 316 infants younger than 2 years of age who were hospitalized for acute viral bronchiolitis. Respiratory tract infection agents were investigated with polymerase chain reaction (PCR). A total of 316 infants were included in this study. Of the 316 infants, at least one respiratory tract pathogen was detected in 75% (237/316). Respiratory syncytial virus (RSV) was the most common virus identified in 127 infants (40.1%) followed by rhinovirus (n = 78, 24.6%). In this study, where viral agents were determined via PCR in patients who were followed-up due to the diagnosis of acute bronchiolitis, RSV was detected as the most common agent, as in other studies. In almost half of the RSV-positive patients, RSV was accompanied by a second or third agent.

A Rare Cause of Childhood Cerebellitis-Influenza Infection: A Case Report and Systematic Review of Literature.

Acute cerebellitis is a benign neurologic condition generally caused by viral or bacterial infections. Influenza associated cerebellitis is extremely rare; a 6-year-old boy with acute cerebellitis, who presented with fever, vomiting, weakness, febrile seizure, and acute cerebellar features, is discussed in this article.

Evaluation of Possible Genotoxic Activity of Dirithromycin in Cultured Human Lymphocytes.

Dirithromycin antibiotic is a 14-membered lactone ring macrolide and is widely used in medicine to treat many different types of bacterial infections. In the present study, the possible genotoxicity of dirithromycin was evaluated in cultured human lymphocytes by using sister chromatid exchanges (SCEs), chromosome aberration (CA), and micronucleus (MN) tests and also cell proliferation kinetics such as mitotic index (MI), replication index (RI), and nuclear division index (NDI) were analyzed for cytotoxicity. Cell cultures were treated with four different concentrations of dirithromycin (37.75, 67.50, 125, and 250 µg/mL) for 24 and 48 h periods. Dirithromycin significantly induced SCE and MN frequency at all concentrations in both 24 and 48 h treated cells. In addition, CA level has been markedly increased in the cells treated with almost all concentrations of dirithromycin for 24 (except 37.75 µg/mL) and 48 h treatment periods as compared to control. However, MI, RI, and NDI values were not affected by the dirithromycin treatment (p > 0.05). The results of this study indicated that dirithromycin treatment caused genetic damage by increasing the level of cytogenetic endpoints, suggesting its genotoxic and mutagenic action on human lymphocytes in vitro.