Excessive screen time and lower psychosocial well-being among preschool children.

OBJECTIVE: Too much screen time is a common and severe threat to child health and excessive screen exposure exists in the early childhood population in Turkey. We aimed to investigate the associations between excessive screen time and psychosocial well-being in a sample of Turkish preschool children. METHODS: Mothers and their healthy children aged 2-5 years who applied to general pediatric outpatient clinics for well-child examinations were enrolled in this descriptive cross-sectional study. Children with a daily screen time of less than 1 h (low) or more than or equal to 4 h (excessive) were included. Psychosocial well-being was assessed using the parent version of the Strengths and Difficulties Questionnaire. RESULTS: In all, 220 mother-child pairs participated in this study. Emotional symptoms, conduct problems, peer relationship problems, and total difficulties scores were significantly higher in the children with excessive screen time (p<0.05), while the hyperactivity-inattention and prosocial scores were not different between the low and excessive screen time groups (p>0.05). After adjusting for potential confounders, the children with excessive screen time had significantly increased odds ratios for having conduct and peer relationship problems (OR [95% CI]: 2.62 [1.11-6.19], p = 0.028 and 2.57 [1.25-5.26], p = 0.010, respectively). CONCLUSION: Turkish preschool children with excessive screen time were significantly more likely to have poor psychosocial well-being. Preschool children with behavioral problems should be evaluated for excessive screen time.

Anxiety level and clinical course of patients with sickle cell disease during the COVID-19 outbreak.

OBJECTIVES: Besides infectious pneumonia and death risks, the COVID-19 pandemic has prompted negative psychological impacts on communities, especially on people with chronic diseases. We aimed to evaluate COVID-19 and sickle cell disease (SCD)-related experiences, and the clinical course during the outbreak, to measure anxiety levels of adolescent and young adult patients with homozygous SCD, to analyze the correlations between their COVID-19 experiences and anxiety levels and painful episodes. METHODS: In this cross-sectional study, 47 patients aged between 14 and 24 years responded to a descriptive instrument and the State-Trait Anxiety Inventory. Clinical features requiring hospitalization for the same period (between March 10 and May 10) of two sequential years were compared. RESULTS: Sixty-six percent of the patients had at least one negative COVID-19 experience of dizziness, sleep disturbance, tonic immobility, appetite loss or nausea/abdominal distress. The number of negative COVID-19 experiences was correlated with the state anxiety score, the trait anxiety score, and the number of painful episodes (ρ=0.552, P<0.001; ρ=0.529, P<0.001; ρ=0.448, P=0.002, respectively). Both median state anxiety and trait anxiety scores were below the cut-off scores indicating significant clinical symptoms. The number of hospitalizations requiring vaso-occlusive crisis management and blood/exchange transfusion were similar for the same period of two sequential years, 2019 and 2020. CONCLUSION: These descriptive and correlation findings are the first reported on COVID-19-related anxiety in SCD patients. To develop screening and support strategies for mental health needs in pandemic times, further SCD studies should be conducted.

Value of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distribution width in distinguishing between reactive lymphadenopathy and lymphoma in children.

OBJECTIVES: The aim of our study was to assess the diagnostic value of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in children with lymphadenopathy (LAP). METHODS: Between January, 2009 and December, 2018, 190 children who underwent excisional lymph node biopsy due to enlarged lymph nodes were included. The clinical and laboratory features of pediatric patients with lymph node enlargement, histopathological examination of the lymph node, and the role of complete blood count parameters in the differentiation of reactive and malignant LAP were analyzed retrospectively. RESULTS: In total, 139 (73.2 %) children had pathologically confirmed reactive LAP and 51 (26.8 %) were diagnosed with lymphoma. Compared with the reactive LAP group, median values for NLR, MLR, PLR, and RDW were significantly higher in children with lymphoma (p < 0.01). According to receiver operating characteristic curve analysis performed for distinguishing between reactive LAP and lymphomas, the area under curves of NLR, MLR, PLR, and RDW were 0.75, 0.76, 0.71, and 0.61, respectively. CONCLUSIONS: Children with histologically proven lymphoma have higher NLR, MLR, PLR, and RDW values than children with reactive LAP. NLR, MLR, PLR, and RDW tests, which can be performed even in primary health care centers, may be useful markers to determine which patients with LAP should be referred to the advanced center at an early stage for biopsy (Tab. 4, Fig. 2, Ref. 26).

Asthma predictive index in relation to respiratory mechanics by impulse oscillometry in recurrent wheezers

Background: The identification of children who will have persistent asthma has become a focus of recent research. The aim of this study was to assess whether impulse oscillometry (IOS) has a diagnostic value to predict modified API (asthma predictive index) in pre-schoolers with recurrent wheezing. Methods: Pre-school children aged 3-6 years with recurrent wheezing were enrolled. The study population was divided into two groups based on mAPI criteria. Lung function was assessed by IOS. Results: 115 children were assessed; 75 (65.2%) of them were male. The median age was 39 months (min: 36, max: 68 months). 64 (55.6%) of the children were mAPI positive. The R5-R20% levels of children with positive mAPI were significantly higher compared to negative mAPI. Also, R5-R20% levels of children with parental asthma and R20% pred and resonant frequency (Fres) levels of children with inhalant sensitization were higher than those without. No significant differences were found in IOS indices between groups based on the presence of atopic dermatitis, food sensitization, eosinophilia, inhaled corticosteroid usage or wheezing without colds. R5-R20% and total IgE values were found to be significantly related to positive mAPI (aOR: 1.40, p = 0.022 and aOR: 1.02, p = 0.001, respectively). In the ROC analysis, R5-R20% levels >14.4 had a sensitivity of 75% and specificity of 53% for predicting a positive mAPI (p = 0.003). Conclusion: IOS may help clinicians to identify the pre-school wheezers with a high risk of asthma (AU)

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Asthma predictive index in relation to respiratory mechanics by impulse oscillometry in recurrent wheezers.

BACKGROUND: The identification of children who will have persistent asthma has become a focus of recent research. The aim of this study was to assess whether impulse oscillometry (IOS) has a diagnostic value to predict modified API (asthma predictive index) in pre-schoolers with recurrent wheezing. METHODS: Pre-school children aged 3-6 years with recurrent wheezing were enrolled. The study population was divided into two groups based on mAPI criteria. Lung function was assessed by IOS. RESULTS: 115 children were assessed; 75 (65.2%) of them were male. The median age was 39 months (min: 36, max: 68 months). 64 (55.6%) of the children were mAPI positive. The R5-R20% levels of children with positive mAPI were significantly higher compared to negative mAPI. Also, R5-R20% levels of children with parental asthma and R20% pred and resonant frequency (Fres) levels of children with inhalant sensitization were higher than those without. No significant differences were found in IOS indices between groups based on the presence of atopic dermatitis, food sensitization, eosinophilia, inhaled corticosteroid usage or wheezing without colds. R5-R20% and total IgE values were found to be significantly related to positive mAPI (aOR: 1.40, p=0.022 and aOR: 1.02, p=0.001, respectively). In the ROC analysis, R5-R20% levels >14.4 had a sensitivity of 75% and specificity of 53% for predicting a positive mAPI (p=0.003). CONCLUSION: IOS may help clinicians to identify the pre-school wheezers with a high risk of asthma.