Predictors of disease course in systemic juvenile idiopathic arthritis.

PURPOSE: To identify potential predictors of the disease course of systemic juvenile idiopathic arthritis (sJIA) at the time of diagnosis. METHODS: This retrospective observational study was conducted in patients diagnosed with sJIA in our hospital between April 2009 and October 2023. The relationship between the disease course of sJIA patients and demographic, clinical, laboratory findings and complications were analyzed. RESULTS: Of the 51 patients diagnosed with sJIA, 26 (51%) patients had monocyclic, 7 (13.7%) polycyclic and 18 (35.2%) persistent disease course. 3 (5.8%) patients had a persistent disease course with persistent arthritis developed flares with systemic manifestations during follow-up. The presence of arthritis, polyarticular involvement, and hip involvement at the time of diagnosis were associated with persistent disease course (p=0.009, p=0.003, p=0.003). Serositis and higher white blood cell and neutrophil counts at the time of diagnosis were associated with a monocyclic disease course (p=0.034, p=0.002, p=0.008). However, no significant correlation was found between macrophage activation syndrome (MAS) and disease course (p=1). CONCLUSIONS: Systemic JIA patients with polyarthritis and hip involvement at disease onset may develop a persistent course. Although MAS is an important complication of sJIA, its effect on the course of the disease was not found in this study.

Association Between Vitamin D Levels and COVID-19 Infection in Children: A Case-Control Study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) infection is seen in all age groups, and its symptoms are very variable. The course of the disease can be asymptomatic or mortal. In pediatric patients, vitamin D is thought to be protective against (COVID-19) with its immunomodulator, antiviral, anti-inflammatory, and epithelial integrity properties. Our aim is to investigate the relationship between (COVID-19) infection and vitamin D level. MATERIALS AND METHODS: We included (COVID-19) patients between 1 month and 18 years of age and healthy control groups. We compared epidemiological, clinical, laboratory, and imaging findings in patients. RESULTS: One hundred forty-nine patients were evaluated in our study. Seventy-three (49%) of them were (COVID-19)-positive patients and 76 (51%) of them were healthy control group. The mean 25(OH)-D vitamin level was 15.80 ng/mL (5-41.56) in (COVID-19) patients and 21.51 ng/mL (5-69.80) in the control group. Vitamin D level was shown to be statistically significantly lower in coronavirus disease 2019 patients (P < .001). It was observed that myalgia was more common in patients with low 25(OH)-D levels (P < .048). CONCLUSION: Our study is one of the rare studies examining the relationship between (COVID19) and 25(OH)-D vitamins in the pediatric age group. Children with (COVID-19) have a lower 25(OH)-D vitamin level than the control group.

Relationship between Serum Endocan Levels and Childhood Community-Acquired Pneumonia.

OBJECTIVES: Community-acquired pneumonia (CAP) is a potentially lethal lower respiratory tract infection for children. For this reason, early recognition and appropriate treatment is essential. In addition, we need to determine which patient will be hospitalized or not hospitalized. Here, we aimed to evaluate the plasma endocan level to determine whether it is effective in making the decision on hospitalization and the assessment of the response to treatment in patients with CAP. MATERIALS AND METHODS: This prospective case-control study was conducted between November 2015 and May 2016 at Erciyes University School of Medicine. Fifty-three patients diagnosed as CAP with clinical and radiological findings were enrolled in the study. The patients were divided into various subgroups, such as inpatient, outpatient, complicated, non-complicated, dead patients, etc., and the levels of endocan were compared between the control group and those various groups. RESULTS: A total of 53 children with a diagnosis of CAP and 55 healthy children were enrolled in the study. Patients were divided into two groups: hospitalized patients and outpatients. There was no statistically significant difference between these groups' serum endocan levels on the 1st day and serum endocan levels on the 4th day (p=0.783, p=0.419). CONCLUSION: Serum endocan level had no significant value in predicting patients' hospitalization. On the other hand, high serum endocrine levels may be important in predicting the severity and prognosis of the disease.

Plasma Kallistatin Levels in Children with Community-Acquired Pneumonia.

Purpose: Community-acquired pneumonia (CAP) is a potentially lethal lower respiratory tract infection affecting children all over the world. In this study, we aimed to evaluate plasma kallistatin levels in children at the time of admission and on the fourth day of treatment to determine if this is effective in deciding whether to hospitalize patients and to assess the response to treatment in patients with CAP. Methods: This prospective case/control study was conducted between November 2015 and May 2016 at Erciyes University School of Medicine, in the Department of Paediatric Pulmonology. Fifty-three patients, who were diagnosed with CAP with clinical and radiological findings, were included in the study. The patients were divided into various subgroups such as inpatients, outpatients, those with complications, those without complications, and dead patients. The levels of kallistatin were compared between the control group and the patient group. Results: A total of 53 children with a diagnosis of CAP and 55 healthy children were enrolled in the study. The plasma kallistatin level of CAP patients at admission was significantly higher than that of the control group [1.6 (1.2-2.9) ng/mL], [0.9 (0.7-1.1) ng/mL] (P < 0.001). The patient group was divided into 3 subgroups: those with complications, those with no complications, and those who died. In patients who were hospitalized, who died, and who were in need of mechanical ventilation (MV), kallistatin levels were significantly higher than in the other patients (P = 0.027 for hospitalization; P = 0.022 for exitus; and P = 0.008 for MV) at the time of diagnosis and on the fourth day of treatment. Conclusion: A higher plasma kallistatin level was found to be significant in CAP. Patients with high kallistatin levels should be carefully monitored for hospitalization and for unwanted side effects such as MV need and death.

Exhaled breath condensate magnesium levels of infants with bronchiolitis.

Demirkan FG, Yilmaz E, Hangül M, Öztürk D, Demirkan H, Soylak M, Köse M. Exhaled breath condensate magnesium levels of infants with bronchiolitis. Turk J Pediatr 2018; 60: 535-539. The aim of this study is to determine the exhaled breath condensate (EBC) magnesium levels of infants with bronchiolitis and to investigate their relationship with disease severity. Fifty infants with moderate and severe bronchiolitis, grouped according to the bronchiolitis clinical severity scores (CSS), and 25 healthy children were included in the study. EBC was collected using an R tube commercial device; flammable atomic absorption spectrometry was used for the identification of magnesium level in this method. The median concentration of EBC magnesium levels in the group of moderate bronchiolitis patients was 0.82 (0-2.71) µg/ml, and that of severe bronchiolitis patients was 0.57 (0-3.16) µg/ml. The median concentration of EBC magnesium levels in the control group was 0.45 (0.06-2.66) µg/ml. There were no significant differences among the three groups (p > 0.559). The magnesium levels of the two bronchiolitis groups were also found in a wide range. In conclusion, EBC magnesium levels were not different in bronchiolitis patients and do not reflect disease severity.

Determination of Patient Learning Needs after Thyroidectomy.

The purpose of this study was to determine discharge learning needs of patients undergoing thyroidectomy. The population of this descriptive study consisted of patients undergoing thyroidectomy in the Endocrine Surgery Unit of a university hospital between February and December 2013. The study included 251 patients who were discharged after thyroidectomy. Data obtained using the data collection form and the Patient Leaning Needs Scale (PLNS) were analyzed by frequency, mean, standard deviation, Kruskal Wallis and student-t tests. The mean age of the patients was 47.91±13.05 and 76.1% were females. The PLNS total mean score was 208.38±34.91, with the maximum score of 39.23±6.80 on the subscale of treatment and complications and the minimum score of 19.45±4.70 on the subscale of feelings related to condition. It was found that the PLNS total score of the patients was not influenced by age, gender, marital status (p>0.05). This study demonstrated that patients had high learning needs after thyroidectomy.

Assessing sexual function and dysfunction in Turkish women undergoing surgical breast cancer treatment.

AIM: The purpose of this study was to determine whether there are differences between Turkish women undergoing postmastectomy breast reconstruction and those undergoing breast-conserving surgery (BCS) or mastectomy alone. METHODS: The sample of the study, which was designed as a descriptive and regressional one, consisted of a total of 100 female patients, 33 undergoing BCS, 34 undergoing postmastectomy breast reconstruction, and 33 undergoing mastectomy for breast cancer, between 2008 and 2012. Data were collected through an individual characteristics form and Female Sexual Function Index (FSFI). RESULTS: The comparison of the type of surgical procedure and the mean FSFI scores for the subscales of desire, arousal, orgasm, satisfaction, and pain, and the mean total FSFI scores revealed a statistically significant difference in favor of postmastectomy breast reconstruction and BCS (P < 0.05). When the authors evaluated the effects of age and surgical procedure type from the risk factors associated with total FSFI score classification by the logistic regression analysis, variations of age and surgical procedure type were found significant in the authors' model (P < 0.05). Age and surgical procedure type were independent risk factors effective on the total FSFI score of less than 26.55. CONCLUSION: In this study, based on the mean total FSFI scores of women, it was concluded that postmastectomy breast reconstruction had positive effects on sexual lives of Turkish women with breast cancer, that more satisfactory outcomes were obtained in those undergoing BCS, that mastectomy had negative effects on sexual function, thus leading to sexual dysfunction, and that age was negatively associated with sexual functions.

The effect of a multispecies synbiotic mixture on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey: single blinded randomized study.

Probiotics have been successfully used for the treatment of acute diarrhea in children and this effect depends on the strains and dose. The aim of this study was to assess the effect of a synbiotic mixture on the duration of diarrhea and the length of hospital stay in children with acute watery diarrhea. This is a prospective randomized, multicenter single blinded clinical trial in hospitalized children with acute watery diarrhea. All children were treated with conventional hydration therapy with or without a daily dose of a synbiotic (2.5 × 10(9) CFU live bacteria including Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium longum, Enterococcus faecium, and 625 mg fructooligosaccharide) for 5 days. The primary endpoint was duration of diarrhea and duration of hospitalization was the secondary endpoint. Among 209 eligible children, 113 received the synbiotic mixture and 96 served as a control. The duration of diarrhea was significantly shorter (∼36 h) in children receiving the synbiotic group than the controls (77.9 ± 30.5 vs. 114.6 ± 37.4 h, p < 0.0001). The duration of hospitalization was shorter in children receiving the synbiotic group (4.94 ± 1.7 vs. 5.77 ± 1.97 days, p = 0.002). The effect of synbiotic mixture on diarrhea started after 24th hours and stool frequency significantly decreased after 24th and 48th hours. The percentage of diarrhea-free children is significantly higher in synbiotic group at 48th and 72nd hours of synbiotic group. In conclusion, this study showed a reduction in diarrhea duration by approximately 36 h and a reduction in the duration of hospitalization with approximately 1 day in children with acute diarrhea with this synbiotic mixture.